Service Provider Frequently Asked Questions

What kind of service provider will qualify for certification?

Any individual or agency currently operating and providing the service, or one similar, in their community may apply for certification. An agency provider must have already procured qualified staff and be providing the service to consumers and have a record for being paid for at least two older adults for at least three months. In addition, it must have documentation supporting compliance with policy, procedural and documentation requirements of the ODA-certified Medicaid Waiver Programs Conditions of Participation and Service Specifications.

A consumer-directed individual provider must demonstrate a person receiving ODA-administered Medicaid waiver program services wants to hire him or her as their service provider before applying for certification.

What are the Conditions of Participation and Service Specifications and how do they apply to the individual applicant?

ODA has established the PASSPORT Conditions of Participation and Service Specifications as the standards by which all PASSPORT services must be delivered. The Conditions of Participation apply to all service providers. The Service Specifications define and set the standards for each individual service and apply only to providers of those individual services.

Must an applicant be a Medicare Certified Home Health Agency or a "traditional" Medicaid agency provider to quality for certification by ODA?

Medicare certification as a home health agency is not a requirement for all ODA-certified Medicaid Waiver Program service providers. However, a certified provider of personal care service that is also a Medicare Certified Home Health Agency and a "Traditional" Medicaid State Plan Home Health provider offers consumers who need both skilled home health services and unskilled personal care services with the most continuity of care options. Though all Medicaid Waiver services must be medically necessary, most ODA-certified Medicaid Waiver services are not medical in nature. Providers who are certified to provide State Plan Medicaid services, Medicare services and ODA-certified Medicaid Waiver Program services only bill each payer source for reimbursement that authorizes a particular service or a particular number of units of service. One exception is that a provider of Enhanced Community Living Service must be certified to provide all three types of services: ODA-certified Medicaid waiver program services, Medicare certified services, and "traditional" state plan Medicaid services.

Is a provider limited to serving in only one of the Ohio Department of Aging thirteen regions or PASSPORT Administrative Agencies (PAAs)?

No. Each applicant is reviewed for certification by the PAA in which their place of business or service origination is geographically located. Once certified, an agency may expand service delivery to other geographic areas. Agencies can be certified to furnish services in any size area for which they can demonstrate they meet the qualifications of the Conditions of Participation and Service Specifications. For instance, a provider of home medical equipment may be able to serve consumers in all of Ohio's eighty-eight counties if the provider only ships a particular item to consumers through a delivery service, while a personal care provider would need to have several regional offices to serve consumers throughout the state in order to meet the requirements to provide supervision of aides, ensure back-up staff and furnish services seven days per week.

Does the agency have to complete another full application to provide services in another PASSPORT Administrative Agency?

No. Once certified to provide services in one region, the provider only needs to request approval to expand into another region by requesting a contract to provide services in another region. The request is made to the regional PAA in the area it wishes to offer services.

Must an agency be or become a traditional Ohio Medicaid service provider to participate in the PASSPORT program?

No. While ODA-certified Medicaid Waiver Programs, including PASSPORT, are Medicaid waiver programs, ODA certification does not make an agency eligible to deliver traditional State Plan Medicaid services in Ohio. ODA-certified Medicaid Waiver Provider enrollment permits the provider to be reimbursed for ODA Medicaid waiver program services only.

Medicare certification as a home health agency is not a requirement for all ODA-certified Medicaid waiver program service providers. However, a certified provider of personal care service that is also a Medicare certified home health agency and a "traditional" Medicaid State Plan home health provider offers consumers who need both skilled home health services and unskilled personal care services with the most continuity of care options. Though all Medicaid Waiver services must be medically necessary, most ODA-certified Medicaid Waiver services are not medical in nature. Providers who are certified to provide State Plan Medicaid services, Medicare services and ODA-certified Medicaid waiver program services only bill each payer source for reimbursement that authorizes a particular service or a particular number of units of service. One exception is that a provider of Enhanced Community Living Service must be certified to provide all three types of services: ODA-certified Medicaid waiver program services, Medicare certified services and "traditional" State Plan Medicaid services.

How does an ODA-certified Medicaid Waiver provider receive reimbursement for services?

Reimbursement for ODA Medicaid Waiver Program services requires the provider to have a Medicaid provider number that indicates it is certified by ODA to provide specific services.

If the applicant is already a provider of traditional State Plan Ohio Medicaid services, does it need to apply for another Medicaid number?

Yes. Reimbursement for ODA Medicaid Waiver Program services requires the provider to have a Medicaid number that has a waiver designation code. The application process begins when the applicant applies for certification through the MITS portal. ODJFS will assign the appropriate waiver designation code to an existing provider Medicaid number or will assign a new number to the provider to be used exclusively for reimbursement of waiver services.

What happens if the applicant does not successfully demonstrate compliance with the Conditions of Participation and Service Specifications?

There are key elements of the Conditions of Participation and Service Specifications that are viewed as basic "structural elements." These identify the agency's basic organizational structure, policies, procedures, documentation formats and current service to the community. Development of a quality community provider base is an ODA value. To ensure consumer choice, we have developed technical assistance mechanisms to assist applicants in understanding and complying with the Conditions of Participation and Service Specifications. The PASSPORT Administrative Agency representative will identify areas of non-compliance and provide a timeframe for corrective action.

What are typical non-compliance findings?

Typical findings are: documentation formats that do not provide for consumer or worker signature, record retention policies that do not meet the six-year requirement, documentation of personnel orientation, qualifications and training and documentation demonstrating compliance with criminal record check requirements. An applicant has only thirty days to clearly demonstrate it is in full compliance with all Conditions of Participation and Service Specifications. If an applicant cannot demonstrate it is in full compliance within the allotted time, the application for certification will be denied and the applicant must wait for a period of one year to reapply.

What will the PAA reviewer expect to see or look at during the on-site pre-certification visit?

The reviewer(s) will be assessing key elements of the Conditions of Participation and Service Specifications. For instance, the reviewer(s) will review consumer files to ensure documentation of service provided is clear and complete and includes required elements such as a record of the tasks completed, date and time of aide's arrival and departure, signatures of both the consumer and aide, evidence that the tasks completed were authorized in the consumer's service plan, evidence the agency nurse conducted an initial assessment of the consumer, etc. The reviewer(s) will also review employee files to ensure documentation clearly indicates the employee was qualified to be hired; the employee underwent a criminal record check, etc. In addition, reviewer(s) will review the provider's table of organization, billing records, and written policies and procedures.

Each specific service that the applicant wishes to furnish adds elements to the initial on-site pre-certification visit. Specific service areas require review or assessment of the elements listed in the Service Specifications of each service, such as documentation of training and skill testing, as well as documentation specific to the service delivered.

 


ODA Direct Service Worker Training Program Approval

Ohio Department of Aging (ODA) approval allows the training program to educate and provide a certificate of completion to direct service workers who are applying to become ODA certified consumer directed personal care providers, Enhanced Community Living service providers or ODA certified individual providers. In no way does ODA's training program approval signify endorsement of the business practices and quality of services provided by any approved direct service training program.

Training Providers: How to Obtain ODA Approval

ODA approved direct service worker training programs include (1) those participating in the Ohio Department of Health Nurse Aide Training and Competency Evaluation Program (NATCEP) and (2) non-NATCEP programs meeting the standards described in the Direct Service Training Program Application for Approval Form B.

The Direct Service Training Program Application for Approval (Including Instructions, Form A and Form B) provides guidance to direct service worker training programs seeking to become approved by ODA.

Non - Nurse Aide Training and Competency Evaluation (NATCEP) Programs with ODA Approval

The Ohio Department of Aging's approval indicates that the direct service training program provider has submitted and met the standards set forth for the elements described in the Direct Service Training Program Application for Approval Form B. The ODA approval allows the training program to educate and provide a certificate of completion to direct service workers who are applying to become ODA certified consumer directed personal care providers, Enhanced Community Living service providers or ODA certified individual providers. In no way does ODA's training program approval signify endorsement of the business practices and quality of services provided by any approved direct service training program.

As applications are received and approved, ODA will publish a list of Approved Direct Service Worker Training Programs that have successfully completed the application process with ODA (including programs at technical schools, colleges, private and non-profit organizations). Many of the programs listed here will offer training and evaluation targeted for direct service workers in home and community based settings.

Ohio Department of Health Nurse Aide Training and Competency Evaluation Program (NATCEP)

NATCEP programs with current approval by the Ohio Department of Health may develop a training program to educate and provide a certificate of completion to direct service workers who are applying to become ODA certified consumer directed personal care providers, Enhanced Community Living service providers or ODA certified individual providers meeting the standards described in the Direct Service Training Program Application for Approval Form B.

NATCEP programs should submit Form A to the Ohio Department of Aging. ODA will publish these programs on the list of Approved Direct Service Worker Training Programs.

The NATCEP unit of the Ohio Department of Health approves nurse aide training programs. The unit oversees both the written competency exam and the clinical skills exam for all nurse aides. The NATCEP unit provides phone assistance to nurse aide programs, nurse aides seeking training and consumers wishing to start new programs.

Home Health Consumers and Prospective Direct Service Workers: Providing Feedback about ODA an Approved Training Provider 

Consumers and direct service workers are encouraged to provide feedback regarding their experience with ODA’s approved training providers.  Please report any issue with an ODA approved training program.

Contact us to provide feedback on our approval process and help us increase the quality of our home health programs.

Links & Resources

 


Alzheimer's Disease Education Resources

The Ohio Department of Aging offers these links to Alzheimer's disease and dementia care training materials for area agency on aging staff, licensed physicians, registered nurses, licensed practical nurses, administrators of health care programs, social workers and other health care and social service personnel who participate or assist in the care or treatment of persons who have Alzheimer's disease or other dementias.

These links are provided for reference purposes only. No endorsement of an organization or its products and services by the Ohio Department of Aging is implied nor should be inferred.

CARES® Training for Ohio Area Agencies on Aging

Training and certification is provided at no cost to area agency on aging staff and volunteers by a grant provided by the Administration on Aging and administered by the Ohio Department of Aging, Alzheimer's Association Chapters in Ohio and Healthcare Interactive®, the leading national provider of online, person-centered dementia care training. Training includes individual certification with Alzheimer's Association essentiALZ® and offers CE opportunity.

Alzheimer's Disease Education and Referral Center (ADEAR)

A service of the National Institute on Aging

Training and Information

Resources

  • AD Lib - The Alzheimer's Disease Library (AD Lib) contains nearly 8,500 materials related to alzheimer's disease, including fact sheets, textbook chapters, journal articles, brochures, manuals and more.
  • Links for Caregivers and Healthcare Providers - ADEAR provides links to resources and information for professionals of multiple disciplines. Included are newsletters, handboks, training materials and more.

Alzheimer's Association

  • Inside Your Brain: An Interactive Tour - The brain tour explains how the brain works and how Alzheimer's affects it.
  • Alzheimer’s Disease Facts and Figures - This report offers a comprehensive statistical abstract of United States data on Alzheimer’s disease
  • Library Services - The Alzheimer’s Association Green-Field Library is the nation's largest library and resource center devoted to increasing knowledge about the clinical, scientific and social aspects of Alzheimer's disease and related dementias.

Ohio Alzheimer's Association Chapters

 

PASSPORT Consumer Direction

 

PASSPORT Services Training