11/09/16

Consumer Directed

What is Consumer Direction

Case study

Identifying appropriateness

Identifying red flags

AAA7 Success- Best Practice

Case study

Final results/outcome

What is consumer directed services

This service option gives PASSPORT consumers more choice and control over their services. Consumers has management and delivery of their services.

The consumer is the one who best knows their needs and how they should be met. So the consumer (or someone they name to act on their behalf) is the one in charge

ODA consumer direction training website link-http://www.aging.ohio.gov/services/passport/

PASSPORT Services Traditional PASSPORT Agency, PCS, HDM, ERS, ADS,

Transportation etc.

Consumer direction service options: PASSPORT Consumer Direction PCS-

Duties: personal care, HMK

PASSPORT Consumer Direction C-HCAS- Duties: personal care, HMK, light home maintenance, and

Transportation.

PASSPORT Consumer Direction Alternative meals

PASSPORT Consumer Direction Pest Control

Consumers can have a mixture of traditional services and consumer direction services

CD PCS-CHCAS Training Requirements

Training requirements and provider has to complete and pass a back ground check before applying to become a Provider.

Review rule OAC 173-39-03, B

The following table compares the training requirement for Personal care service and Choices Home Care Attendant service.

Personal Care Service Choices Home Care Attendant Service

Worker must be certified as an STNA, HHA, or

have completed 60 hour ODA approved training

program.

They will need 12 hours of continued education

annually

Worker must have skills training; certificate in Basic

Home Safety and Universal precautions of infection

control,

Verified training of Activities of daily living,

communication/administration and rule review.

They will need 8 hours of continued education

annually

Obtaining training

Providers can find training available locally or on line. Some can be free and some may have a cost. The provider is responsible for any costs.

Examples of Local training resources are Red Cross, Community Action Centers, Jobs First through the Department of Job and Family Services, local vocational school, Home Health Agencies,

Care Star online Training Website. http://www.carestar.com/en-us/services/onlineeducation/onlineceus.aspx

Collins online Training web site;www.collinslearning.com

Case Study example 7 year OHCW consumer, who has 2 independent providers

for service who wants to maintain current providers.

There is a history of multiple agency services challenges due to consumer being demanding and hard to serve.

Consumer is alert and oriented, total care/bed bound, has depression, anxiety with small wound on left heal.

Has no use of legs or arms and has slight movement of left hand.

Has 1 supportive daughter who works full time and the relationship is extremely strained with outbursts at times.

The Consumer is turning 60 and has to transition to PASSPORT.

Consumer considerations Must be eligible and enrolled on PASSPORT

A paid Provider cannot be: the Consumer spouse, parent, legal guardian, DPOA, POA, Authorized Representative or a person who will be directing the care

The Consumer/Authorized Representative wants to direct their own care

Have a stable active care giver they can assign as Authorized Representative IF they want and/or need one

Develop a viable backup plan for care/service delivery

Consumer considerations

Must have the capacity to manage and make decisions regarding their daily care, including scheduling and instructing the provider

Possess problem solving and communication skills

Have a stable environment/support system

Ability to recruit, interview, hire, supervise, terminate

Flexible, advocate for self

Consumer Ability considerations

Complete pre scheduling of at least two providers (individual and/or provider agency)(paid or unpaid)

Have budgeting skills, Complete timesheets, Manage daily activities

Ability to work with Care Manager and Morning Sun

Keep home personnel records organized and available for AAA-7, ODA, and ODM review

Red flags/barriers The Consumer/Authorized Representative allows the

Provider to influence decisions of care and service hours

Consumer is inflexible/demanding

The Authorized Representative becomes the paid provider

Consumer cannot manage daily activities

Consumer has history of not being able to maintain consistent stable providers

Red flags continued

Consumer does not exhibit ability to recruit, interview, hire, supervise, terminate

Consumer does not possess problem solving and communication skills

Consumer has no stable support system

Consumer has a history of service issues

If a Red flag item is Identified, it does not prohibit the consumer from Consumer Direction service options.

AAA7 work with the consumer to try and eliminate the red flag concern/s , focus on strengths, eliminate weaknesses/barriers, and support them for success.

AAA7 supportive role for Consumer Direction success

(Best Practices)

Assessors are trained in consumer direction and if CD is requested at assessment- Assessors review CD, leave handout on Provider ODA application process and notify the CD specialized team

The special Team contacts consumer to schedule Home visit initial training

Care Managers are also trained in CD and they review with the consumer at first Home visits, ongoing contacts, and annual Assessments.

Care Managers make referral to the CD specialized team and case is transferred for CD support.

AAA7 has a specialized team who are specifically trained in Consumer Direction education/training.

Once Consumer Direction is identified- we transfer the Consumer to the specialized team for support thru process.

They provide Care Management as well as ongoing Consumer Direction education/training/support

AAA7 provides descriptive handouts/training tools Consumer manual, Provider application handout, Provider

Training handout, filing guide

Supportive role

AAA7 provides One on One phone support with consumer/provider if difficulties arise during the provider certification process

Referring potential providers to Community organizations for assistance with cost of BCII and training to help obtain/maintain employment.

Workforce One Job Stops/JFS, CAO, Recovery Counsel, Vocational Rehabilitative services, etc.

Coordinating services – Educating the provider of applying at an Agency and becoming the CD provider

Agency bills Medicare/Medicaid service and Consumer bills PASSPORT

We have assisted those with physical Challenges to find techniques/alternative ways to direct

Scheduling, unit verification/billing-signature

Physical/Occupational /Speech Therapy

Signature

Communication boards

Maintaining files

Opportunities for Ohioans with Disabilities

Magnifiers for enlargement of text

Technology

Signature stampers

Scanning image to Television

Computers

Supportive tasks for success

If the consumer choses an already approved provider, AAA7 expedite the process and conduct all training at once with the MSF payroll packets.

Ongoing communication with all involved in consumers care; Waiver care manager, Family, Provider

Educating family on community resources,

addiction treatment, Mental Health , crisis hotline, housing

Provide a file box with inserts on record keeping

Once the provider is ODA approved- AAA 7 simultaneously complete,

AAA7 provider contracts

Final consumer direction Training

Morning Sun referral

Case Study example 7 year OHCW consumer, who has 2 independent providers

for service who wants to maintain current providers.

There is a history of multiple agency services challenges due to consumer being demanding and hard to serve.

Consumer is alert and oriented, total care/bed bound, has depression, anxiety with small wound on left heal.

Has no use of legs or arms and has slight movement of left hand.

Has 1 supportive daughter who works full time and the relationship is extremely strained with outbursts at times.

The Consumer is turning 60 and has to transition to PASSPORT.

Goal:

Have a seamless transition, with the consumer being able to maintain the same providers with no

disruption or negative impact.

Case study outcome From assessment 5/5/16- the assessor identified the

consumer could direct care with scheduling and instructing the providers, left provider application instructions

The consumer requested to maintain current service providers

Already has a calendar filled out for prescheduling around Daughters work schedule,

Consumer has a signature stamper for signing,

Daughter to assist with filing and assigned as Authorized Representative for back up.

Plans to Hire a 3rd already approved ODA provider to reduce caregiver stress to Daughter

Outcome continue

Initial CD training conducted 5/26/16 , for education and training, confirmed independent provider applying to ODA.

9/6/16 AAA7 Pre-certification completed.

9/21/16 Provider is ODA approved.

9/21/16 request for Morning Sun to mail consumer enrollment packet to consumer.

Outcome continue

9/27/16 Consumer calls to report has Morning Sun packet and is completing. Home visit scheduled for 10/4/16

Final training 10/4/16 with completion of MSF packet.

10/11/16 MSF packet sent with effective date 10/25/16.

OHCW Care manager issues discharge notice of 10/24/16

Good to go issued by Morning Sun 10/19/16

PASSPORT enrollment 10/25/16 with CD providers as well as Medicaid Skilled Agency service and CD providers as the Home health aide.

Believing the consumer can direct, empowering them to direct, providing the tools needed with ongoing education/training/support is key to the success of the consumer.

Summary

Questions????

The End.