Ohio

Main Contact: 
Tonya Hawkins: Tonya[dot]Hawkins[at]medicaid[dot]ohio[dot]gov
NWD/SEP System
Name of Operating Agency: 
Ohio Department of Medicaid
Participating types of NWD/SEPs: 
Twelve Aging and Disability Resource Centers, known as ADRNs (Aging and Disability Resource Networks) serve as the base for the NWD system
1-800 number: 
(844) 644-6582
Level I screen: 
The assessment tool is accessible to beneficiaries from NWD website, contacting an ADRN through the 1-800 number or in person at the ADRN. The Level I tool uses the Level II screening decisions as a guide.
Level II assessment: 
Agencies currently determining eligibility for Medicaid LTSS will continue this function
Agency responsible for completing the financial assessment: 
County Department of Jobs and Family Services
Coordination/automation of referrals between levels (i.e., Level I and Level II) : 
After completing the Level I screen online, by communicating with an ADRN through the toll-free number or in person at the ADRN, the individual is automatically referred to either a community-based service or to the appropriate agency for a Level II
Core Standardized Assessment
Elderly individuals (age 65 or older): 
Adult Comprehensive Assessment Tool (ACAT)
People with developmental disabilities: 
Adult Comprehensive Assessment Tool (ACAT); Child Comprehensive Assessment Tool (CCAT)
People with a serious mental illness or severe emotional disturbance: 
Adult Comprehensive Assessment Tool (ACAT); Child Comprehensive Assessment Tool (CCAT)
People with physical disabilities: 
Adult Comprehensive Assessment Tool (ACAT); Child Comprehensive Assessment Tool (CCAT)
Conflict-Free Case Management
Mitigation strategies in place/planned: 
OH incorporated conflict-free tenets into the managed care plan contracts for the financial alignment demonstration. OH also developed firewalls for case management within their Aging system.
Service data: 

Ohio makes use of claims data and encounter data. OH will use CMS 372 Form (Medicaid Waivers) Reports to establish that the programs are cost effective and cost neutral and to report participation levels for the services rendered to individuals and families who meet the eligibility criteria in each waiver. It also uses National Medicaid HCBS data to note expenditures by their service categories, and uses CMS 64 Form Reports to judge participants access to both community and institution LTSS.

Quality measures: 

Ohio uses the Medicaid Adult Health Quality Measures and the NCQA/HEDIS measures based on claims data. It is also conducting reviews of Medicaid waivers and using various waiver performance measures

Outcomes data: 

Ohio uses the Mental Health Statistics (MHSIP) survey and the Youth Satisfaction for families survey to measure service access, quality and appropriateness of services, and perceived outcomes. It also conducted a Money Follows the Person (MFP) Quality of Life survey and the National Core Indicators (NCI) survey.

Use of Enhanced FMAP: 

OH used its enhanced FMAP to expand capacity of its 1915(c) waiver services, including PASSPORT, Choices, Assisted Living, Ohio Home Care, Transitions Carve-Out, Individual Options, Level One, SELF, and Transitions DD. OH increased home health, private duty nursing, and behavioral health state plan services. Finally, OH expanded its Program of All-Inclusive Care for the Elderly (PACE) and case management.