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Advocacy Corner July 28th, 2021

ADVOCACY CORNER

AROUND THE STATE

HCBS Rate Increase Implementation

OCHCH met with ODM Director Maureen Corcoran and ODA Director Ursel McElroy who laid out a plan for the home and community based services rate increase of 6.1% . The increase will be implemented in November 2021! While the rate increase will NOT be retroactive, they are implementing the total 6% increase now rather than implementing the increase as 4% this year and 2% next year. Find out more information here:

(blog post)

“The state biennium budget was signed on July 1 and included a 6% increase for home health services across the board (4% increase in FY22 and 2% increases in FY23). While Governor DeWine vetoed that increase, he also committed to implemented the rate increase as the General Assembly directed.

OCHCH participated today in a virtual meeting with ODM Director Maureen Corcoran and ODA Director Ursel McElroy, respectively, and they laid out the plan for rate increase. We’re now able to report that a rate increase of 6.1% will be implemented in November 2021! While the rate increase will NOT be retroactive, they are implementing the total 6% increase now rather than implementing the increase as 4% this year and 2% next year.

Services that will get this rate increase include: PDN, nursing, aide, personal aide, home maker/personal care, OT, PT, and speech therapy, and assisting living waiver. These increases will apply to state plan, waiver, and managed care!

While we would have loved for these increases to be applied July 1, the delay to November is for good reason. To implement the increases there needed to be changes made to rules, waiver and SPA amendments, and ODA/AAA contracts as well. This takes time to coordinate, but rest assured OCHCH will continue to engage and advocate for speedy rate increase implementation.

Lastly, ODM released its plan to spend the enhanced FMAP dollars from the American Recovery Act (ARPA) and there are good things coming. Ohio plans on making a $450 million investment into Medicaid HCBS services and infrastructure. This points to good things ahead for our industry. ODM is convening a workgroup to develop the specifics of how Ohio will spend the money and OCHCH will be a primary stakeholder in the process. Stay tuned for more on that!

Thanks again to everyone who participates in our advocacy efforts! We’ve got more work to do but we’re here now because of your contribution. Thank you! If you have questions about the rate increases, please email the OCHCH Helpdesk at Helpdesk@ochch.org. Thanks!”

Ohio Releases Long Awaited ARPA Medicaid Spending Plan

On March 13th, President Joe Biden signed into law H.R. 1319, the American Rescue Plan Act of 2021. As part of that legislation, Congress included a 10% increase to state FMAPs to supplement—and not supplant—the level of state funds expended for HCBS beginning April 1st. Ohio spent months to create an initial spending plan to submit to CMS for the estimated $460 million dollars for home and community based services. ODM IS LOOKING FOR FEEDBACK! As a primary stakeholder in that effort, OCHCH is collecting information to help support our advocacy efforts.

Please take a moment to share the impacts that COVID-19 has had on your staffing, costs, and revenue amounts for home health and hospice. It is crucial that our request for funding is supported by data from Ohio providers. Please complete by Monday, August 2. Click this link: https://www.surveymonkey.com/r/M6LP53X

Check out the long awaited ODM initial spending plan here: (Josh please create a link for the document titled “2021 ODM ARPA Spending Plan” and insert that link)

You can see OCHCH’s proposal to ODM for the ARPA spending plan here: (Josh please create a link for the document titled “ODM letter on HR 1319” and insert that link)

OCHCH meets with Ohio Department of Health

The ODH quarterly meeting for Non-Long Term Care providers was held July 21, 2021.  During the meeting the ODH survey process was discussed as well as Home Health licensure. Learn more about the meeting here. (Link to blog post)

ODH surveys have resumed for Home Health and Hospice agencies.  Because surveys were stopped for several months, there is a back log of surveys to be done.  ODH is currently doing surveys due now and some of the backlogged surveys.  When determining which surveys will be done, ODH is looking at geographical location in an effort to maximize resources.  Also if a complaint survey is done and the agency is due for their recert survey, ODH will do both during the survey visit.  

Surveys are being done in person with some survey activities being done remotely if there is limited office space and social distancing cannot be done.  Home visits are being done by the surveyors.  ODH states most patients have been willing to allow surveyors into their homes.  Infection Control continues to be a focus during the survey process.  ODH stated they have not identified any survey finding trends and Plan of Care continues to be the most frequently cited area.

ODH stated they are having internal discussions about Home Health licensure—all Home Health Agencies will fall under licensure.  Once the internal discussions have concluded, ODH will in invite OCHCH and other stakeholders to discuss the rule making process.

TAKE ACTION

http://report.nahc.org/wp-content/uploads/2019/08/NAHC-Advocacy-300x161.jpg

In conjunction with the National Association for Home Care and Hospice (NAHC) OCHCH is teaming up to have Ohio home health agencies contact their Congressman/women and Senators to advocate for Medicare reimbursement for telehealth services. We are asking for Congress to support the Home Health Emergency Access to Telehealth (HEAT) Act (S. 1309/H.R. 3371) Check out the Fact Sheet created by NAHC:Factsheet 

Click HERE to advocate and tell your congressional office to support the Home Health Emergency Access to Telehealth (HEAT) Act (S. 1309/H.R. 3371)

UPCOMING OCHCH-PAC EVENTS

 2nd Annual OCHCH-PAC Golf Outing

Back by popular demand, the OCHCH-PAC Golf outing is returning on August 6th at Safari Golf Club in Powell, Ohio. Last year’s outing was a massive success and we are excited to offer you the opportunity to come back for another round.

Course is limited to only 36 teams, so don’t wait. The deadline to sign up is TODAY, so sign up online https://www.ochch.org/pac/golf/. Pre-registration is a must. If you don’t preregister we can’t guarantee you can golf.

See here for more details:

(Blog post)

When: FRIDAY, August 6, 2021 AT 8:30AM (registration begins at 7:30am)
Where: Safari Golf Club; 4850 Powell Rd, Powell, OH 43065 (right across from the Columbus Zoo) 

What: Shotgun start golf outing; 4 Person Scramble

Includes: 18 holes of golf, cart, range balls, return round of golf worth $25, breakfast and lunch, 3 drinks tickets per person, game prizes and more!

Games: 50/50, longest drive, closest to the pin, longest putt

Awards: prize for each game, one prize for one attendance ticket, prize for the winners of the first ever OCHCH PAC Golf Outing

Cost:

Single golfer: $150

(or) Foursome: $450 – 4 Mulligans and 4 Gimmies included!

Hole Sponsor: $175 (max 18)

*Drink Sponsor: $1500 

*Breakfast Sponsor: $1500

*Lunch Sponsor: $1500

*Note – Drink and Food Sponsorships include a team of 4 with price of sponsorship.

*Political Action Committees are prohibited by state law from accepting contributions from corporations. As a result, all contributions must come from individuals, partnerships, or LLCs, not corporations. Political Action Committee contributions are not tax deductible. All contributions are completely voluntary. You may refuse to contribute without reprisal. Any proposed contribution amounts are merely suggestions; you may choose to contribute more or less or not at all. OCHCH PAC will not favor or disadvantage anyone by reason of the amount contributed or the decision not to contribute. All materials prepared and paid for by OCHCH PAC.*

STATE BILL TRACKING

S.B. 209 Mask Mandates (O’BRENNER)—upon enactment would block schools from imposing their own mask mandates and would also require businesses that require customers to wear a mask to post a notice about their rule.

Click HERE to view ALL the state legislation that we’re tracking at the state level!

FEDERAL BILL TRACKING

S. 2344 Supporting Our Direct Care Workforce and Family Caregivers Act (SEN. TIM KAINE)—would provide approximately $1 billion in grant money to states to support projects/ programs that are focused on recruitment, retention, and training for direct care workers and family caregivers. You can see more information about the bill here.

RULES REPORT

OCHCH Submitted Rule Comments:

On 7/15/2021, OCHCH submitted comments for ODA’s rule review in efforts to eliminate outdated modes of communication, such as requiring use of a fax machine, unnecessary paperwork, or applying for something in person.

Read more to see what OCHCH submitted and the list of rules that ODA reviewed.

(Blog) “We appreciate the efforts to standardize/ reduce burden for home health agencies. One of the main barriers for our providers is the low reimbursement rates not only through the PASSPORT program, but the entire home and community based services spectrum. As you consider reducing administrative burden, we ask that you also consider the reimbursement rates, which in most cases, does not cover the cost of providing care. As Ohio’s population continues to age, we wish to continue to keep individuals safe and receiving care within their homes.

Chapter 173-9 Background Checks: One burden that is experienced by providers is the lengthy process of obtaining a background checks. As you know, our members are currently facing a workforce shortage, thus the need to hire/ recruit and retain staff is critical. However, the barrier is the time it takes to actually receive the results of the background check by mail. It is taking approximately four weeks to obtain a background check by mail which is causing a delay in hiring staff. I have brought up this issue with the AGs office and BCI is also aware of this issue. We hope that there is a solution to obtain these records electronically so that our agencies can continue with swift hiring processes.

OAC 173-39-02.11 providers are directed to Section 121.36 | Contracts entered into by department for provision of home care services to home care dependent adults.  In some cases, there are  AAA is refusing to accept EVV data as proof of home health aides being at homes delivering care, and will insist that the agency continue to make random calls to homes to verify that the aides are there.  However, other regional AAA’s do/ and WILL accept EVV data as proof of a visit. We suggest that ODA should remove the requirement of the phone calls, which is an additional administrative burden for agencies, and accept the EVV data as proof of aides in the homes.

OAC 173-3-06.5 | Older Americans Act: personal care Section 4: Lastly, we wish for ODA to consider extending the RN supervisory visits . Ohio requires care to be performed under the scope of an RN, which is could be viewed as unnecessary for a truly non-medical service. Ohio still requires an RN supervisory visit every 60 days. The 60 day recertification period increases undue regulatory burden.

Thank you very much for your consideration, please let me know if you have any questions.”

(Include chart with blog post above)

General  Older Americans Act ProgramsGolden Buckeye ProgramBackground ChecksSenior Facilities ProgramProvider CertificationLong-Term Care Consultation ProgramLong-Term Care Consumer Guide
Chapter 173-1  Chapter 173-3Chapter 173-6Chapter 173-9Chapter 173-11Chapter 173-39Chapter 173-43Chapter 173-45
173-1-02  173-3-01173-6-01173-9-06173-11-03173-39-01173-43-02173-45-03
173-1-03  173-3-04173-6-02173-9-07 173-39-02173-43-03173-45-06
   173-3-05173-6-03173-9-07.1 173-39-02.1 173-45-06.2
   173-3-05.1173-6-04173-9-08 173-39-02.4 173-45-09
   173-3-06173-6-05  173-39-02.7 173-45-10
   173-3-06.1173-6-06  173-39-02.8  
   173-3-06.2173-6-07  173-39-02.10  
   173-3-06.3173-6-08  173-39-02.12  
   173-3-06.4   173-39-02.13  
   173-3-06.5   173-39-02.20  
   173-3-06.6   173-39-03  
   173-3-09   173-39-03.1  
       173-39-03.2  
       173-39-03.3  
       173-39-03.4  
       173-39-04  

Rules Up for Comment:

ODA

Request for comments due 7/30/2021 at 8:00am

After OCHCH’s submission of the 7/15/2021 rule comments (see blog post here), ODA is now planningto re-review the rules for any supplementary improvements. ODA will accept any recommendations for improvements. Please send your comments/ suggestion to the rules to Alex Weingarth at alex@ochch.org by 8:00am Friday, July 28, 2021.  (include link to 7/15/2021 blog link)

ODM

Request for comments due 8/09/2021 at 8:00am

OCHCH intendeds on reviewing and submitting comments to ODM for the following rules below. You may see a summary of proposed changes here. If you would like you participate in the rule commentary process, please send your comments/ suggestion to the rules to Alex Weingarth at alex@ochch.org by 8:00am Friday, August 9, 2021.

Rule NumberAgencyTagline
5160-36-04Ohio Department of MedicaidProgram of all-inclusive care for the elderly (PACE) enrollment, disenrollment, and waiting lists
5160-44-05Ohio Department of MedicaidNursing facility-based level of care home, community-based services (HCBS) programs and specialized recovery services (SRS) program: incident management
5160-44-31Ohio Department of MedicaidOhio Department of Medicaid (ODM) -administered waiver programs: provider conditions of participation
5160-45-03Ohio Department of MedicaidOhio department of medicaid (ODM) -administered waiver program: individual rights and responsibilities
5160-45-04Ohio Department of MedicaidOhio department of medicaid (ODM) -administered waiver program: provider enrollment process
5160-45-06Ohio Department of MedicaidOhio department of medicaid (ODM) -administered waiver program: structural reviews of providers and investigation of provider occurrences
5160-46-04Ohio Department of MedicaidOhio home care waiver: definitions of the covered services and provider requirements and specifications
5160-46-06.1Ohio Department of MedicaidOhio home care waiver program: home care attendant services reimbursement rates and billing procedures

Proposed Rule Changes:

ODA proposes to correct a cross reference in paragraph (C)(4) of rule 173-3-07 of the Administrative Code (consumer cost sharing). Please see the rule here.