October 1, 2021
Updated Rules for Adult Day Support and Vocational Rehabilitation
*Please note that this is the corrected version sent by DODD on 9/30/21*
The updated rules for Adult Day Support (OAC 5123-9-17) and Vocational Habilitation (OAC 5123-9-14) take effect on October 15, 2021. These updates include changes to Adult Day Support (ADS) and Vocational Habilitation (VH) services provided in an integrated community setting for a group of five or fewer individuals. When the updated rules go into effect, the Community Integration Add-on that is currently utilized to reimburse services provided in non-facility-based settings to small groups will no longer be available. Instead, new service codes have been established that will pay for ADS and VH services provided in an integrated community setting for a group of five or fewer individuals at the rates established for Acuity Group C (the highest rates available for ADS and VH services).  
 
The Medicaid Services System (MSS) will not be updated to fully accommodate the new service codes for Community ADS and Community VH until sometime in December 2021. This will create an interim period where the service authorizations for people who are currently receiving the Community Integration Add-on will need to be changed to authorize the use of the service codes currently established to represent the Start Toward Emerging Possibilities (STEP) services in order for costs to be projected accurately.
 
DODD has identified the individuals who currently have a Community Integration Add-on in MSS that crosses the 10/15/2021 date. This report has a list of 789 individuals from 47 counties and will be shared in a separate email with the counties impacted by this change. The following steps must be taken for the cost projections for these individuals:
·    Each person’s costs projection will need to have the ADS/VH services that include the Community Integration Add-on ended effective 10/14/2021.
·    STEP services will need to be authorized effective 10/15/2021.
·    STEP services will be paid out at the C rate for acuity, and DODD will continue to have the system by-pass the acuity budget for those with these services.
·    Prior Authorization of Waiver Services (PAWS) will also be able to be enrolled by the county boards if the cost projection is over the Adult Acuity Instrument (AAI) budget for the person, but the units are less 6,500. 
·    Outliers that need DODD assistance to override a PAWS submission can be sent to MSSSupport@dodd.ohio.gov.
 
After MSS is updated with the new service codes for Community ADS and Community VH, all cost projections that contain STEP service codes will need to be updated to reflect the new service codes and this can be done next time services need to be updated in the CPT site.
We understand that this is not ideal and apologize for the inconvenience. We have tried to minimize the need for cost plans to be touched twice as best we can. Thank you for your understanding. If you have further questions or concerns, please reach out to DODD at jessica.mcgonigle@dodd.ohio.gov.
2022 Waiver and Nursing Rate Increases
DODD will be doing another automated rate change within the Medicaid Services System (MSS) for waiver services and nursing services that were recently approved to receive rate increases. The new rates will go into effect for the waiver services on 01/01/2022, and the nursing services will be effective 11/01/2021. The consent form within MSS will open at 6 AM on 10/01/2021 and remain open until 4 PM on 10/14/2021. County boards will be permitted to choose to allow DODD to run only finalization/authorization or to run finalization/authorization and PAWS submission. For Waiver Nursing, DODD will be running all approved finalizations.
 
DODD will only be running this automated rate change one time. Please be sure you have consented within the time frame as noted above.
 
Once DODD has received consent, DODD will run the automated rate change process for individuals with payment authorizations that meet all of the following criteria:
·    the waiver span crosses 01/01/2022 for waiver services,
·    the waiver span crosses 11/01/2021 for nursing services,
·    the plan is enrolled, and finalization was done prior to 11/12/2021.
 
Due to the amount of waiver and nursing services being affected, the rate automation will be running across several weekends in November. DODD will communicate the dates once we know how many counties sign up for the rate automation. When the rate automation runs, it will run from 4 PM on a Friday and finish up at 8 AM on Monday. During this time, MSS will be down and unavailable to all users. If issues arise, we will communicate to everyone.
 
If you have any questions please feel free to reach out to Jessica.mcgonigle@dodd.ohio.gov.

Thanks for Coming to Our Table Talk!
Thank you for joining us and Tamara Lentini, Nurse and Manager from CDD Health Services to chat about Provider Health Services hot topics, the new Provider Certification Rule and training requirements. We hope you'll join us again for our October Table Talk, tentatively scheduled for October 28th. Watch the newsletter for details!
Staffing Efforts
Cuyahoga DD has posted lists on our website of Independent Providers who are willing to work with an agency, as well as a list of agencies who are in need of staff. These lists are updated and posted regularly. If you would like to be added to either list, please complete the appropriate survey below. Additionally, if you'd like to be removed from these lists for any reason, please email PDS.

*Please note that this list has been revised. Only Providers who completed the survey in the past 90 days have remained on the list. If you are no longer on it but wish to be, please complete the survey again.*
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