Tips for Providing the New Day Services - Constant Contact

Tips for Providing the New Day Services - Constant Contact

Tips for Providing the New Day Services 1 2 Relax and Breathe! 3 The New Day Services ** Any day, any time ** Day services are no longer limited to Monday

through Friday during the day. The new day services offer more flexibility to meet the individualized needs of the people we support Tracking the utilization of budgets will be more important than ever 4 The New Day Services General FAQs Concerning the New Day Rules The new day budget limits were calculated based on 260 days of services. Must we provide 260 days of service? No. Offering day services 260 days a year is optional. Most providers are not open 260 days a year, if only

because they are closed on major holidays. So why raise the limits? Some of the new DODD day array services are more expensive per unit, so some individuals will need the extra money to access these services even if they use the same or less service days. 5 The New Day Services General FAQs Concerning the New Day Rules Do providers still need to meet the staff intensity ratios as they have in the past or is this changing? Per 5123:2-9-19, In the old rule, there are multiple references to staff intensity ratios. In the new rules, it is referred to group assignments. The service-specific rules

include the limitation of group sizes of no more than 16 people. Section (E)(5) of 5123:2-9-19, states agency providers shall ensure and document that sufficient numbers of staff are engaged in provision of adult day support, group employment support, and vocational habilitation to ensure the health and safety and achievement of outcomes identified in the individual service plans of individuals being served; submission of a claim for payment constitutes an attestation by the agency provider that sufficient staff were present to ensure health and safety and achievement of outcomes. No more than sixteen individuals may receive services in one group, irrespective of the funding source for the services being provided to the individual participants. Keep in mind that all Career Planning as well as Individual Employment Support shall be provided at a ratio of one staff to one individual per 5123:2-9-19. The New Day Services New Budget Limitations

6 Based on 260 days of service (6500 units/year) CODB Group A Group A-1 Group B Group C 1

$10,270 $10,270 $18,460 $30,745 2 $10,335 $10,335 $18,655

$31,070 3 $10,465 $10,465 $18,850 $31,395 4 $10,595

$10,595 $19,045 $31,720 5 $10,660 $10,660 $19,240 $32,045

6 $10,790 $10,790 $19,435 $32,370 7 $10,920 $10,920

$19,630 $32,630 8 $10,985 $10,985 $19,760 $32,955 7

The New Day Services NMT Budget Increase 8 Adult Day Support Overview Supports the individual's membership in the community Enhances opportunities for personal growth, independence, and natural supports Can include volunteer opportunities 9 Adult Day Support Tips for

Providers Must be in compliance with CMS Setting Rule Paying individuals for work done during day services is allowable in some instances Must be in Compliance with DOL Wage and Hour Law when paying minimum wage (and subminimum wage?). If you are paying the people you support, are you treating them as employees? https://www.dol.gov/whd/ Providers cannot use Medicaid money to pay the individuals they support 10 Adult Day Support Tips for

Providers May bill the daily rate for Adult Day Support only when all of the following apply: The provider delivers only Adult Day Support to the person on that day; AND The provider delivers between 5 7 hours of Adult Day Support that day; AND The provider elects not to receive the community integration, the medical and/or behavior add-ons (continued on next slide) 11 Adult Day Support Tips for Agency Providers Use the 15-minute billing unit for Adult Day Support

when: The provider delivers Adult Day Support and an employment service, including Vocational Habilitation, on the same day; OR The provider delivers less than 5 or more than 7 hours of Adult Day Support that day; OR The provider elects to receive the community integration, medical and/or behavior add-ons Vocational Habilitation Overview 12 Supports the individual's membership in the community (required to meet the HCBS Setting Rule) Enhance general, transferrable employment-related skills

Is a step toward competitive, integrated, employment & Individuals in Voc Hab will eventually be required to have a goal of integrated, competitive employment*** Time limited Can include volunteer opportunities **Authorizing and billing for vocational habilitation is similar to Adult Day Support ** 13 Vocational Habilitation Tips for Providers Must be in compliance with the WIOA when paying subminimum wage(Workforce Innovation and Opportunity Act) http://www.ood.ohio.gov/Portals/0/EF%20Taskforce%2

0Joint%20Guidance%20Section%20511.pdf If volunteering, must be in compliance with DOL Regulations concerning unpaid work http://www.ohioemploymentfirst.org/up_doc/SELN_Unp aid_Work_Volunteer_February_2017.pdf (Continued on next slide) 14 Vocational Habilitation Tips for Providers Can include incidentals such as personal care and assistance preparing meals and eating Must be in Compliance with DOL Wage

and Hour Law when paying minimum wage (and subminimum wage?). If you are paying the people you support, are you treating them as employees? https://www.dol.gov/whd/ Providers cannot use Medicaid money to pay the individuals they support 15 Individual Employment Support and Group Employment Support Tips for Providers The service currently known as Supported Employment Community will be discounted on

March 31 and replaced by Individual Employment Support on April 1st. The service currently known as Supported Employment Enclave will be discontinued on March 31st and replaced with Group Employment Support on April 1st. SSAs must make this change in PAWS so that providers can continue billing for these services. (Continued on next slide) 16 Individual Employment Support and Group Employment Support Group Tips forEmployment

Providers Support, similar to the current Supported Employment Enclave, has both a daily rate and a 15-minute unit rate option. 5123:2-9-15(B)(13)(a) "When job coaching is provided, a plan outlining the steps to reduce job coaching over time shall be in place within thirty calendar days. Medical and Behavioral Add-Ons Apply if billing 15 minute unit 17 Medical and Behavioral Add-ons If a person qualifies for behavior and/or medical add-ons, the add-ons

are available for both HPC and Day Services, even if the add-ons were given for a reason applicable to only to HPC or Day Services Community Integration Add-on 18 Community integration add-on is available when the provider takes individuals out into the community Group size of 4 or less Each staff person providing community integration must have completed DODD training Providers need to keep proof of staff training on file

Must bill using 15-minute unit (no daily rate) Multiple add-ons can occur at once 19 FAQ: Community Integration Addon Do providers need to enter staff certification in Community Integration into DODDs Certification Wizard? No. Providers do need to keep staff certification on file for OPSR review. Where can providers go to become certified in community integration for the add on? The community integration recorded webinar is now available on the DODD website. This is an on demand version of the required training for direct care staff, if the provider agency is authorized and elects to receive the community integration rate modification for the Adult Day Support or Vocational

Habilitation services. To view the recorded webinar, log into DODD MyLearning at https://mylearning.dodd.ohio.gov/. Click Add-on Trainings then Community Integration Recorded Webinar" and select the button that says "Enroll Me." Certificates are available upon completion of the webinar and an 80% or higher score on quiz questions embedded throughout the presentation. 20 Career Planning Overview Are provided one on one Support a person's community employment goals Can lead directly to individualized employment through job development

Can be provided in conjunction with other services Career Planning Services/Components 21 1. Situational Observation and Assessment 2. Career Exploration 3. Benefits Education and Analysis 4. Career Discovery 5. Employment/Self-Employment Plan 6. Job Development 7. Self-Employment Launch 8. Worksite Accessibility 9. Assistive Technology

22 Situational Observation and Assessment Overview Observation and assessment of the individual's interpersonal skills, work behaviors, and vocational skills through practical, experiential, community integrated, paid work experiences related to the individual's preferences as established in the individual service plan. Information gathered through situational observation and assessment provides a context to further determine the skills or behaviors to be developed by the individual to ensure his or her success in the individual's preferred work environment. Time limited , not to exceed 30 days Maximum of 4 units per plan year Outcome-Based Payment $813.15 A written report must be submitted to the SSA for payment (see rule

for documentation specifics) 23 Situational Observation and Assessment Tips For Agency Providers Must complete application on DODDs Certification Wizard Notable Training Requirements - Each staff must complete at least eight hours of training specific to the provision of career planning within one year of hire unless the staff has a least one year of experience providing career planning at the point of hire (see rules for

details!) 24 FAQ: Situational Observation and Assessment The new Career Planning services include a paid Situational Observation and Assessment service. Who pays the wages of the participants for this services? The rule does not outline who is required to pay the pages; this is up to the provider who is doing this component of service. It is important to remember that Medicaid dollars cannot be used to pay wages; therefore, this was not included in the rate setting procedure. In an ideal situation, the employers will pay the wages of the participants.

If a provider does choose to pay the individuals participating in this program, they will need to ensure they are not using Medicaid monies to pay wage. They will also need to follow DOL Wage and Hour Law. 25 FAQ: Situational Observation and Assessment How many days/hours of Situational Observation and Assessment are required for the provider to get paid? The rule does not outline the required days/hours needed to receive payment. What it does outline is that no situational observation/assessment should

exceed 30 days, and a maximum of 4 authorizations for this component of career planning can be done within an individuals waiver eligibility span. Career Exploration Overview 26 Career exploration assists an individual to interact with job holders and observe jobs and job tasks. Informational interviews Job shadowing Opportunity to perform actual job duties when

possible $13.55 per 15 minute unit for agency providers $8.50 per 15 minute unit for independent providers Medical and Behavioral Add-ons are applicable 27 Career Exploration Tips for Providers Must complete application on DODDs Certification Wizard Agency Provider Notable Training Requirements - Each staff must complete at least eight hours of training specific to the provision of career planning within one year of

hire unless the staff has a least one year of experience providing career planning at the point of hire (see rules for details!) 28 Benefits Education and Analysis Overview Provides information concerning impact of paid employment on a range of public assistance and benefits programs to job seekers, families, guardians, advocates, service and support administrators, and educators Outcome-Based Payment of $285.00 A written report must be submitted to the SSA for payment (see rule for documentation specifics) Maximum of 4 units per plan year

Benefits Education and Analysis Tips for Providers 29 Must complete application on DODDs Certification Wizard Notable Training Requirements Agency employees and independent providers must have successfully completed nationally approved or accredited training in benefits education and analysis. AND Agency Provider - Each staff must complete at least eight hours of training specific to the provision of career planning within one year of

hire unless the staff has a least one year of experience providing career planning at the point of hire (see rules for details!) 30 Career Discovery An individualized, comprehensive process to help a job seeker, who is interested Overview in working in the community, to reveal how interests and activities of daily life may be translated into possibilities for integrated employment. Incudes the identification of the individual's interest in the job market based on:

skills strengths conditions necessary for the individual's successful employment or self-employment. Results in a written career discovery profile Outcome-Based Payments by Acuity: A: $1,084.20, A-1: $1,084.20, B: $1,626.30, C: $2,168.40 Maximum of 4 units per plan year 31 Career Discovery Tips for Providers Must complete application on DODDs Certification Wizard Agency Provider Notable Training

Requirements - Each staff must complete at least eight hours of training specific to the provision of career planning within one year of hire unless the staff has a least one year of experience providing career planning at the point of hire (see rules for details!) Employment/Self-Employment Plan Overview 32 Creation of a plan for employment or the start-up phase of self-employment that includes; A planning meeting involving the job seeker and other key people who will be

instrumental in supporting the job seeker to become employed in competitive integrated employment Results in a written employment plan directly tied to the results of career exploration, if previously authorized, situational observation and assessment, and/ or career discovery. For individuals seeking self-employment, this service results in the development of a self-employment business plan that identifies training and technical assistance needs and potential supports and resources for those services as well as potential sources of business financing (cannot be financed with Medicaid funds)

Outcome-Based Payment of $813.15 A written plan must be submitted to the SSA for payment (see rule for documentation specifics) 33 Employment/Self-Employment Plan Tips for Providers Must complete application on DODDs Certification Wizard

Agency Provider Notable Training Requirements - Each staff must complete at least eight hours of training specific to the provision of career planning within one year of hire unless the staff has a least one year of experience providing career planning at the point of hire (see rules for details!) 34 Job Development Overview Strategy to attain competitive integrated employment in a position consistent with the individuals career goals. May include; analyzing a job site identifying necessary accommodations

negotiating with an employer for customized employment $13.55 per 15 minute unit for agency providers $8.50 per 15 minute unit for independent providers Medical and Behavioral add-on are applicable Cant be used by individuals on place 4 of the path to community employment 35 Job Development Tips for Providers Must complete application on DODDs Certification Wizard Agency Provider Notable Training Requirements - Each staff must complete at least eight hours of training specific to the provision of career planning

within one year of hire unless the staff has a least one year of experience providing career planning at the point of hire (see rules for details!) 36 Self-Employment Launch Overview Implement a self-employment business plan and launch a business consistent with the individuals career goals $13.55 per 15 minute unit for agency providers $8.50 per 15 minute unit for independent providers

Medical and Behavioral add-on are applicable Cant be used by individuals on place 4 of the path to community employment 37 Self-Employment Launch Tips for Providers Must complete application on DODDs Certification Wizard Agency Provider Notable Training Requirements - Each staff must complete at least eight hours of training specific to the provision of career planning within one year of hire unless the staff has a least one year of experience providing career planning at the

point of hire (see rules for details!) 38 Worksite Accessibility Overview Identifying and ensuring reasonable worksite accommodations that allow the job seeker or job holder to gain, retain, and enhance employment or self-employment $13.55 per 15 minute unit for agency providers $8.50 per 15 minute unit for independent providers Medical and Behavioral add-on are applicable 39 Worksite Accessibility Tips for Providers

Must complete application on DODDs Certification Wizard Notable Training Requirements Agency employees and independent providers demonstrate that he or she holds an appropriate license (e.g., occupational therapist) or certification (e.g., certified professional ergonomist issued by the "Board of Certification in Professional Ergonomics"), or has successfully completed appropriate training by an accredited college or university. AND Agency Provider - Each staff must complete at least eight hours of training specific to the provision of career planning within one year of hire unless the staff has a least one year of experience providing career planning at the point of hire (see rules for details!) 40 Assistive Technology Assessment Overview

Application of technologies, engineering methodologies, or scientific principles to meet the needs of, and address the barriers encountered by, individuals with disabilities in employment and employment-related transportation. Assessment & Services including; making home or employment site visits

measurements of the physical environment or equipment developing technical drawings researching potential modifications fabrication and installation of modifications

computer programming to provide for accessibility training on utilization and maintenance of modification Outcome Based Rate of $352.30 Maximum of 4 units per plan year 41

Assistive Technology Assessment Tips for Providers Must complete application on DODDs Certification Wizard Notable Training Requirements Agency employees and independent providers have appropriate license (e.g., occupational therapist) or certification (e.g., assistive technology professional certification issued by the "Rehabilitation Engineering and Assistive Technology Society of North America"), or has successfully completed appropriate training by an accredited college or university. AND Agency Provider - Each staff must complete at least eight hours of training specific to the provision of career planning within one year of hire unless the staff has a least one year of experience providing career planning at the point of hire (see rules for details!) FAQ: Career Planning

42 Can you bill on behalf of for career planning? Yes, per 5123:2-9-13. Career planning services may extend to those times when the individual is not physically present while the provider is performing career planning activities on behalf of the individual. But that conflicts with this rule? per 5123:2-9-17, section (F)(4) A provider of adult day support shall not bill a daily billing unit on the same day the provider bills fifteen-minute billing units for the same individual. Remember, Some components of career planning are billed in 15 minute units. DODD has confirmed that rule 5123:2-9-17 is stating that providers cannot bill 15 minute units of voc hab or day support when billing the daily rate for voc hab and day support, but that billing for 15 minute units of on behalf of services at the same time as the billing for the daily rate is okay.

Keep in mind, Rule 5123:2-9-17 section (5) Payment for adult day support, career planning, group employment support, individual employment support, and vocational habilitation, alone or in FAQ: Career Planning 43 Can transition youth use Career Planning services? Yes . 5123:2-9-13 (D)(2) states: The service and support administrator shall ensure that documentation is maintained to demonstrate that the service provided as career planning to an individual enrolled in a waiver is not otherwise available as vocational rehabilitation services funded under section 110 of the Rehabilitation Act of 1973, 29 U.S.C. 730, as in effect on

the effective date of this rule, or as special education or related services as those terms are defined in section 602 of the Individuals with Disabilities Education Improvement Act of 2004, 20 U.S.C. 1401, as in effect on the effective date of this rule. This enables transition-age youth to use the service, but does require verification that the service is not otherwise available through the school or OOD. Braiding DODD and OOD Funding According to the DODD, the SSA ensures that documentation is maintained to demonstrate that the services provided as vocational

habilitation, individual employment supports, career planning, and /or group employment supports to an individual enrolled in a waiver are not otherwise available as VR services, or as special Braiding DODD and OOD Funding The county board is not required to obtain an ineligibility form from OOD before HCBS waiver-funded employment services can be provided. Documentation (e.g. case note) that the service is not otherwise available through VR or school should be maintained in the individuals file.

Braiding DODD and OOD Funding It should also be noted that this language does not require an individual to first be referred to OOD/VR before HCBS waiverfunded employment services can be provided. The team should explore all possible resources prior to HCBS waiver services, and the SSA will need to justify if OOD/BVR services Braided Funding: case study Angela is attending a sheltered workshop and says she may want to get a part-time job, while maintaining her connection to the workshop for a

couple days a week because she has several friends there, and she likes the staff. She lives in a supported-living home with two housemates, and has had no community-based work experience. At 36, shes worked mainly on assemblage work in the facility, making below minimum wage. She receives SSI and SSDI, and both she and her mother (and her payee) are worried about her losing benefits based on wages. Shes told her home manager that she wants to work with dogs and cats, but has not had any experience. When asked further, she says she Braided Funding: case study Well get started with a Benefits Education and Analysis, so Angela and her mother can have some answers to their questions. Benefits Education and

Analysis provides information to job seekers, families (and others) about the impact of paid employment on a range of public assistance and benefits programs. Since Angela has never had actual community-based work experiences, and only seems to have one kind of vocational goal in mind, Career Discovery might be a way to help her come up a valid plan, based on informed choice: Career Discovery is an individualized, comprehensive process to help a job seeker () reveal how interests and activities of daily life may be translated into possibilities for integrated employment. Braided Funding: Action steps Angela also might benefit from Situational Observation and Assessment, to test her skills and to see if she really

is interested in, and can do the job of, taking care of animals. These supports will help determine the skills or behaviors to be developed by Angela to be successful, as well as reveal the conditions necessary for her success. Once Angela and her team get some solid information concerning actual work experiences and abilities, they can plan more effectively and then navigate toward next steps, including possibly referring to the Employment First Partnership. 50 Resources 51

http://www.ohioemploymentfirst.org/up_doc/ SELN_Unpaid_Work_Volunteer_February_2017.pdf Employment First 52 http://www.ohioemploymentfirst.org/ 53 http://www.ohioemploymentfirst.org/ view.php?nav_id=111 Resources DODD Website 54

http://dodd.ohio.gov/Training/Pages/default.aspx 55 Resources DODD Website http://dodd.ohio.gov/Training/Pages/Timeline.asp x Resources DODD Website 56 http://dodd.ohio.gov/Training/Pages/ImplementationPlanning.aspx Resources for Benefits Education 57

Nationally approved or accredited training in benefits education and analysis: Cornell University Online Course http://www.edionline.org/ 58 LOOP Ohio https://loopohio.org/ 59 DODD Rules in Effect http://dodd.ohio.gov/RulesLaws/Pages/RulesI nEffect.aspx

60 DODD Rules in Development http://dodd.ohio.gov/RulesLaws/Pages/RulesUnder-Development.aspx 61 THE END

Recently Viewed Presentations

  • Ministry of EnvironmentEnvironmental Protection Branch

    Ministry of EnvironmentEnvironmental Protection Branch

    Ministry of EnvironmentEnvironmental Protection Branch. ... need to formalize a comprehensive solid waste management strategy in order to address the entire solid waste management life-cycle and consider best practices for disposal, stewardship and recycling, and education. ... and improves the...
  • American Imperialism - Weebly

    American Imperialism - Weebly

    American Imperialism. What is Imperialism? The policy in which stronger nations extend their economic, political, or military control over weaker territories. Is expansion a common theme in American History? What is the term associated with this? Should we consider the...
  • Fight, Flight, or Negotiate: Believable Strategies for Conversing

    Fight, Flight, or Negotiate: Believable Strategies for Conversing

    Assess sincerity Strategically adopt strategies Which are most likely to lead to adoption of helpful strategies by other Display orientation (whether actually held or not) Coping With Negotiation Orientations: Initial Model in SASO-ST project Extended Virtual Humans to have orientations...
  • Dr. Pam Riegle & Jamie Johnson Ball State

    Dr. Pam Riegle & Jamie Johnson Ball State

    Dr. Pam Riegle & Jamie Johnson Ball State University Every institution is different…..what may work for us may not work for you. The mission, personnel, facilities, and funding of individual departments guide us.
  • REM 663 - SFU.ca - Simon Fraser University

    REM 663 - SFU.ca - Simon Fraser University

    Piketty: Piketty's thesis did not arise suddenly with the writing of "Capital in the 21st Century", but rather over many years with the help of other (as he says "…several dozen…") scholars in the construction and analysis of a large...
  • 1818 ACC Chemistry

    1818 ACC Chemistry

    Electromotive Force. An EMF doesn't have to be a battery, it's just that batteries are by far the most common. What is needed is a source of a potential difference, an electromotive force (EMF), symbolized by
  • NECSTouR conference - Torrent

    NECSTouR conference - Torrent

    NECSTouR IS THE VOICE OF REGIONS FOR . SUSTAINABLE & COMPETITIVE TOURISM. 36 Regional Authorities. 30 Associated and Academic Members. 12 Years of Experience
  • LEARNING NEEDS ASSESSMENT LEARNING NEED ASSESSMENT  An attempt

    LEARNING NEEDS ASSESSMENT LEARNING NEED ASSESSMENT An attempt

    LEARNING NEED ASSESSMENT. An attempt to describe the gap in knowledge , attitude and skills that exist as compared to the desired level they need to function appropriately in their daily work