Area Office on Aging of Northwestern Ohio Services
Area Office on Aging of Northwestern Ohio provides Home and Community Based Medicaid Waiver services, including personal care, homemaking, home-delivered meals, emergency response system, home modification, and more. The program covers individuals under age 60 who require skilled level care, offering an alternative to nursing facility placement. Eligibility criteria and details about the services are outlined, along with information on the State Plan coverage and Private Duty Nursing services available. Additionally, Healthchek, the children's health component of Medicaid, ensures children under 21 receive necessary medical services. Helpful links for further resources are provided.
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Presentation Transcript
AREA OFFICE ON AGING OF NORTHWESTERN OHIO, INC. Jayne Wagner RN, Associate VP of clinical services Billie Johnson President & CEO
OHCW WHAT IS OHCW? WHAT SERVICES DOES IT COVER? HOME AND COMMUNITY BASED MEDICAID WAIVER TO PROVIDE HOME AND COMMUNITY BASED SERVICES INSTEAD OF THE INDIVIDUAL HAVING TO BE IN A NF. PERSONAL CARE/HOMEMAKING HOME DELIVERED MEALS EMERGENCY RESPONSE SYSTEM HOME MODIFICATION VEHICLE MODIFICATION DURABLE MEDICAL EQUIPMENT STATE PLAN MEDICAID PAYS FIRST
OHCW WHO IS ELIGIBLE? WHO IS NOT ELIGIBLE? UNDER AGE 60, SERVICES CAN BE MET BY STATE PLAN (CORE OR BASE MEDICAID) INTERMEDIATE OR SKILLED LEVEL OF CARE, MUST HAVE SKILLED LEVEL OF CARE IF PART OF DODD. LACK OF STAFFING DOES NOT MAKE YOU ELIGIBLE. DOESN T QUALIFY FOR MEDICAID. RESIDES IN THE COMMUNITY NEEDS A RULE-OUT FROM DODD OR HAVE A SKILLED LEVEL OF CARE. HAS A WAIVER NEED BEYOND WHAT MEDICAID STATE PLAN PROVIDES SKILLED NURSING 7 DAYS A WEEK OR THERAPY 5 DAYS A WEEK PLUS AN UNSTABLE CONDITION MEDICAID ELIGIBLE
STATE PLAN WHAT STATE PLAN DOESN T COVER 14 HOURS A WEEK OF SKILLED NURSING/AIDE RESPITE CARE PRIOR AUTH: 28 HOURS HOMEMAKING ONLY (COVERS HOMEMAKING INCIDENTAL TO THE PERSONAL CARE) CHILDREN WITH PRIOR AUTH CAN HAVE MORE HABILIATATIVE CARE MORE HOURS AFTER HOSPITALIZATION NON-PARENT/ NOT LG/NOT AR FAMILY CAN BE PAID CAREGIVER
PRIVATE DUTY NURSING PRIVATE DUTY NURSING More than 4 hours at a time but less than 12 hours MEDICAL NECESSITY APPLICATION SKILL NEEDS FORM Prior Authorization required Services typically are for ventilators, tube feedings, suctioning.
Healthchek Healthchek is the children s health component of Medicaid for children under age 21. Under Healthchek, your child can receive medically necessary services or equipment that would be covered by federal Medicaid whether or not the service is covered by Ohio's Medicaid plan for adults. Also, your child can get more of a certain service than would be provided to adults. For example, a child could get more physical therapy than an adult would get if the added therapy is medically necessary for the child. Children also can get more dental care than adults. Once your child is enrolled in Ohio Medicaid, he or she can receive Healthchek services. Ask the Healthchek Coordinator at your County Department of Job and Family Services (CDJFS) for more information about Healthchek services. A list of county Healthchek Coordinators can be found at: http://medicaid.ohio.gov/Portals/0/ For%20Ohioans/Programs/countycoor dinators.pdf
CMH (BCMH) CHILDREN WITH MEDICAL HANDICAPS https://odh.ohio.gov/wps/portal/go v/odh/know-our-programs/children- with-medical-handicaps/questions The Children with Medical Handicaps Program (CMH) has three core programs for children with special health care needs: Diagnostic Treatment Service coordination Each program requires medical and/or financial criteria to be met before a child/adult can be eligible to receive CMH services. CMH does not pay for in-home nursing services. CMH links families of children with special health care needs to a network of quality providers and helps families obtain payment for the services their children need. CMH is a state-administered program that operates within ODH. For diagnostic services, there is no income eligibility required. For treatment services, families must meet CMH income guidelines.
