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CONNECT TO | Policy & Legislation
March 2011

Consumer-directed personal care providers added to PASSPORT Medicaid waiver
Another choice in receiving PASSPORT services

Administrative rules will be effective March 17, 2011, that allow older Ohioans to employ consumer-directed care providers, as well as agency providers, in the PASSPORT Medicaid waiver program. Previously, program participants could access only home health agencies when receiving personal care. Soon, they will be able to hire other individuals, such as neighbors, friends and some relatives, to provide services, such as bathing, dressing and toileting.

consumer-directed personal care provider

The use of consumer-directed personal care providers is a different way of delivering PASSPORT personal care services. It will give consumers the option to hire their providers for their most intimate service, which involves bathing and grooming. The flexibility of scheduling services at times preferred by the consumer, and selecting the person who provides the service are principles of consumer direction.

Agency providers will continue to be the prevalent source of services in the PASSPORT program. Only about four percent of participants are expected to be interested in and determined appropriate for consumer direction. A case manager will work with consumers to decide not only if consumer direction is an appropriate option, but also if the consumer is capable of fulfilling the employer responsibilities that come with the option. Based on data from other states and Ohio's experience with the Choices waiver, the majority of consumers will continue to use the agency-based PASSPORT model.

A waiver case manager will provide oversight to assist the consumer with self-directed personal care. The consumer also may choose an authorized representative to help with the day-to-day supervision of their service provider and to assist with employer-related tasks. A financial management agency, also known as a fiscal intermediary, will work with consumers to handle the taxes, payroll and worker's compensation responsibilities of being an employer.

All consumer-directed personal care providers are required to meet established training requirements, at the individual's expense, and to undergo criminal background checks prior to working for a PASSPORT consumer. The pay rate for consumer-directed care will be less than the current rate paid to agency providers and will be paid at a set rate statewide. Federal law prohibits spouses, parents or legal guardians from being paid caregivers.

Home health agencies can apply on the ODA website to provide training programs to consumer-directed personal care providers.

The Ohio Unified Long-term Care System Workgroup unanimously included among its recommendations, that Ohio expand its consumer-directed services for people on Medicaid in order to help balance the state's long-term care system. Several areas of Ohio already have consumer direction available to elder consumers through the Choices Medicaid waiver. Adding the consumer direction option to PASSPORT is the quickest and most efficient way to extend the benefits of consumer-directed services to all of Ohio.

Connect to More
Policy & Legislation

The Office of Ohio Health Plans (OHT)
The Governor's Office of Health Transformation (OHT) is pleased to announce the launch of its new website. The site will serve as a portal for information about Ohio's health transformation initiatives. It also provides an opportunity for stakeholders to sign up for email updates and to share ideas about how to modernize Medicaid.

LIHEAP funding cuts
Due to new federal Health and Human Services (HHS) obligation methodology - not budget cuts - Ohio will receive less than 50 percent of its 2010 allocation for the federal Low Income Home Energy Assistance Program (LIHEAP): $110 million for 2011 versus a base allocation of $223 million in 2010. Ohio's Office of Community Services (OCS) will be forced to close the state's HEAP program early and to completely eliminate the Summer Crisis Program, which provides cooling assistance for elderly and disabled Ohioans. OCS reports that the new methodology punishes Ohio's prudent management of funds. Advocates are asking HHS for the immediate release of $100 million in LIHEAP contingency dollars to Ohio to partially offset the cut in funding, and requesting that HHS revert to the standard needs based formula. A third Continuing Resolution is expected in March, when the final funding level will be set.


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