國家機(jī)關(guān)辦公建筑和大型公共建

1、國家機(jī)關(guān)辦公建筑和大型公共建Home Care AttendantNew Rules OAC 5101:3-46-04.1 (Ohio Home Care Waiver Program: Home Care Attendant Services) OAC 5101:3-46-06.1 (Ohio Home Care Waiver Program: Home Care Attendant Services Reimbursement Rates and Billing Procedures)OAC 5101:3-50-04.1 (Transitions Carve-Out Waiver Prog

2、ram: Home Care Attendant Services) OAC 5101:3-50-06.1 (Transitions Carve-Out Waiver Program: Home Care Attendant Services Reimbursement Rates and Billing Procedures)2國家機(jī)關(guān)辦公建筑和大型公共建Home Care AttendantHome Care Attendant Services:Permits unlicensed individuals (non-agency providers) to assist consumer

3、s with:Self administration of medicationsPerformance of certain skilled tasks that would otherwise be completed by a nursePersonal care tasks3國家機(jī)關(guān)辦公建筑和大型公共建HCA services are provided to consumers in lieu of nursing services. HCA services are not in lieu of personal care aide services.4國家機(jī)關(guān)辦公建筑和大型公共建H

4、ome Care AttendantHCA can assist with certain medications including:Oral medications (includes medication administered through a metered dose inhaler)Topical medications (includes medication applied to outer skin, including transdermal medications and eye, ear and nose drops, vaginal or rectal suppo

5、sitories)Subcutaneous injections of routine doses of insulin5國家機(jī)關(guān)辦公建筑和大型公共建Home Care AttendantHCA can assist with certain medications including:Programming of a pump to administer routine doses of insulinMedication via stable, labeled gastrostomy or jejunostomy tubesDoses of schedule II, III IV or V

6、 drugs only when administered orally or topically6國家機(jī)關(guān)辦公建筑和大型公共建Home Care AttendantNursing tasks that Home Care Attendants can not perform:Intravenous insertion, removal, or discontinuationIntramuscular injectionsIV medication administrationSubcutaneous injections (except for routine doses of insuli

7、n)7國家機(jī)關(guān)辦公建筑和大型公共建Home Care AttendantNursing tasks that Home Care Attendants can not perform:Programming of a pump to deliver medications (including epidural, subcutaneous and IV), except routine doses of insulinInsertion or initiation of infusion therapiesCentral line dressing changes8國家機(jī)關(guān)辦公建筑和大型公共建

8、HCAs who provide activities to a consumer in accordance with the limitations as set forth in the rules, including activities in accordance with the authorizing health care professionals authorization shall not be considered to be engaging in the practice of nursing as an RN or LPN in violation with

9、the Nurse Practice Act.9國家機(jī)關(guān)辦公建筑和大型公共建HCAs must:Not be the consumers authorized representative.Not be the consumers legally responsible family member as defined in 5101:3-45-01 of the Ohio Administrative Code.Not be the consumers legal guardian or foster parent.10國家機(jī)關(guān)辦公建筑和大型公共建The HCA will secure th

10、e services of a RN, in agreement with the consumer and/or authorized representative.The HCA must participate in face-to-face visit upon the initiation of services and every 90 days thereafter with the consumer, authorized representative, and the RN for the purpose of monitoring the consumers health

11、and welfare.The RN will serve as a resource for the purpose of answering any questions that the HCA, consumer, and/or authorized representative have about the consumers needs, medications and other issues.11國家機(jī)關(guān)辦公建筑和大型公共建The face-to-face RN consultation visit activities shall be documented by the HC

12、A and the RN in the consumers clinical record.The HCA will discuss the results of the face to face consultation visit with the CM and the consumer and/or authorized representative.12國家機(jī)關(guān)辦公建筑和大型公共建Clinical Records must be maintained by the HCA for each consumer in a manner that protects the consumers

13、 privacy and confidentiality of these records.HCA must maintain the clinical records at their place and business and also maintain a copy at the consumers residence.The HCAs place of business is considered to be a location other than the consumers residence.13國家機(jī)關(guān)辦公建筑和大型公共建The HCAs clinical record m

14、ust include the following information:Consumers identifying information, including, but not limited to: name, address, age, date of birth, race, marital status, significant phone numbers and health identification numbers.Consumer medical history.14國家機(jī)關(guān)辦公建筑和大型公共建HCAs clinical record must include the

15、following information:(continued)Names and contact information for all of the consumers licensed health care professionals.Copy of the initial and subsequent all service plans.Documentation of all allergies and dietary restrictions.15國家機(jī)關(guān)辦公建筑和大型公共建The HCAs clinical record must include the following

16、information:(continued)A copy of any advance directives, including but not limited to a “do not resuscitate order” (DNR) or a “medical power of attorney” if they exist.The ODJFS 2389 and 2390 Forms as appropriate.16國家機(jī)關(guān)辦公建筑和大型公共建 HCAs clinical record must include the following information:(continued

17、)Documentation of HCA services performed or not performed, arrival times, departure times, and the dated signature of the provider, and consumer or authorized representative, verifying service delivery upon completion. Nothing shall prohibit the use of technology-based systems. The consumers or auth

18、orized representatives signature of choice shall be documented on the consumers all services plan, and shall include, but not be limited to the following forms: handwritten signature, initials, a stamp or mark, or electronic signature. 17國家機(jī)關(guān)辦公建筑和大型公共建 HCAs clinical record must include the following

19、 information:(continued)Copy of the log detailing the count and reconciliation of schedule II-V drugs for which the HCA is assisting consumer with self-administration.18國家機(jī)關(guān)辦公建筑和大型公共建 HCAs clinical record must include the following information:(continued)Progress notes, signed and dated by the HCA d

20、ocumenting all communications with the CM, licensed health care professionals, including the authorizing health care professional, other members of the multidisciplinary team.19國家機(jī)關(guān)辦公建筑和大型公共建 HCAs clinical record must include the following information:(continued)Documentation of the face-to-face vis

21、its at the initiation of service, and every 90 days with HCA, consumer and the authorized representative and the RN.For the first visit, document that CM was present. The documentation should include issues discussed at the visit.20國家機(jī)關(guān)辦公建筑和大型公共建 HCAs clinical record must include the following infor

22、mation:(continued)Discharge summary that is signed and dated by the departing HCA when services are no longer provided. The summary should include documentation regarding progress made toward achievement of the goals as specified in the all services plan.21國家機(jī)關(guān)辦公建筑和大型公共建HCAs must:22國家機(jī)關(guān)辦公建筑和大型公共建To

23、be reimbursed as a HCA, the provider must be identified and specified on the consumers all services plan that has been prior-authorized prior authorized by ODJFS or its designee.23國家機(jī)關(guān)辦公建筑和大型公共建Upon request of the consumer or the consumers authorizing health care professional, the HCA must perform a

24、 successful return demonstration of the service to be provided.Meaning the consumer or the authorizing health care professional can ask the HCA to perform in front of the them a specific task to determine that the HCA has the ability to correctly perform task. What does this mean?24國家機(jī)關(guān)辦公建筑和大型公共建HCA

25、 must complete at least 12 hours of continuing education regarding HCA services annually. Evidence of completion must be submitted to the department no later than the annual anniversary date of the issuance of the HCAs initial Medicaid provider agreement.25國家機(jī)關(guān)辦公建筑和大型公共建Continuing education topics c

26、an include but are not limited to the following:Consumer health and welfareCPRPatient rightsEmergency preparednessCommunication skillsAging sensitivityDevelopmental stagesNutritionTransfer techniquesDisease-specific trainingsMental health issues 26國家機(jī)關(guān)辦公建筑和大型公共建The consumer, authorized representativ

27、e, and provider shall report to the case manager all instances that a HCA appears to have:Provided nursing services, other than assistance with self-medication or the performance of nursing task authorized in the rules.Provided services not in accordance with the tasks and assistance with self-medic

28、ation which had been approved by the authorizing health professionals authorization.Who (in the department) receives this reported information?27國家機(jī)關(guān)辦公建筑和大型公共建ODJFS may initiate an investigation based on the report of a HCA providing inappropriate services and shall report the findings to the Ohio B

29、oard of Nursing.28國家機(jī)關(guān)辦公建筑和大型公共建Home Care AttendantProvider EnrollmentNew Provider Type 26-Home Care Attendant Interested providers will need to complete a new provider application with HCA provider addendumRequired for all providers including existing waiver providers29國家機(jī)關(guān)辦公建筑和大型公共建ODJFS agrees to

30、 enter into a provider agreement with an individual to provide HCA services to a consumer enrolled on the following waivers:Ohio Home Care WaiverTransitions Carve Out Waiver30國家機(jī)關(guān)辦公建筑和大型公共建The HCA must:Agree to comply with all Medicaid provider requirements in Division 5101:3 of the Administrative C

31、ode.Agree to comply with all of the waiver provider requirements in 5101:3-45, 5101:-46 and 5101:3-50 of the Administrative Code.31國家機(jī)關(guān)辦公建筑和大型公共建The HCA must:Agree to comply with the requirements in 5111.88 and 5111.8811 of the Revised Code and all requirements set forth in this rule.32國家機(jī)關(guān)辦公建筑和大型公共

32、建HCA shall not provide services until:ODJFS approves the JFS 2389/ 2390 Home Care Attendant Medication Administration Authorization or Home Care Attendant Skilled Nursing Task Authorization that contains the following:Written consent from the consumer or authorizing representative allowing the HCA t

33、o provide HCA services, and assuming responsibility for supervising the activities of the HCA. When there is authorized representative, who is supervising activities of the HCA, they will be present and awake during the delivery of the services.33國家機(jī)關(guān)辦公建筑和大型公共建Written consent from the consumers auth

34、orizing health care professional attesting that the consumer and or the authorized representative have demonstrated the ability to monitor the consumer-specific HCA service for the consumer. This consent includes all of the following:Consumers name and address;Description of the specific nursing tas

35、k or self-administration of medication that the HCA will assist consumer, including the self-administration of medication, name of medication, dosage, and route of administration;Times or intervals when HCA is to assist with self-medication of each dosage of medication or performance of nursing task

36、s;34國家機(jī)關(guān)辦公建筑和大型公共建This consent includes all of the following: (continued)Dates which HCA is to begin and end providing assistance;List of severe adverse reactions that the HCA must report to the consumers health care professional if one should occur;At least one telephone number which the HCA can re

37、ach the consumers health care professional in an emergency for consultation after contacting an emergency personnel;At least one fax number that the HCA can reach the authorizing health care professional when the HCA observes that the scheduled medications) is missing or can not be reconciled.35國家機(jī)關(guān)

38、辦公建筑和大型公共建This consent includes all of the following: (continued)Instructions the HCA must follow when assisting the consumer with performance of a nursing task or self-administration of medications, including, but not limited to instructions for maintaining sterile conditions and for storage of tas

39、k-related equipment and supplies.36國家機(jī)關(guān)辦公建筑和大型公共建HCAs must:Be at least 18 years oldProvide HCA services to consumer enrolled on the Ohio Home Care Waiver or Transitions Carve Out Waiver37國家機(jī)關(guān)辦公建筑和大型公共建To make application as a HCA, the individual must have a valid Social Security number and one of th

40、e following forms of identification:Alien IDState of Ohio IDValid Drivers License38國家機(jī)關(guān)辦公建筑和大型公共建HCA applicant must:Provide ODJFS evidence to its satisfaction of all of the following:HCA either meets the personnel qualifications as specified in 42 CFR 484.4 for home health aides, or has successfully

41、 completed at least one of the following:Competency evaluation program, or training and competency program by the Ohio department of health39國家機(jī)關(guān)辦公建筑和大型公共建A training program approved by the department that includes training equivalent to a training and competency evaluation program (CSTO-Consumer Sp

42、ecific Training Option) which includes:Basic Home SafetyUniversal PrecautionsConsumer-specific personal care aide servicesThe labeling, counting, and storage requirements for schedule II, schedule III, schedule IV and schedule V medications40國家機(jī)關(guān)辦公建筑和大型公共建HCA must provide ODJFS a certificate of comp

43、letion of a first aid course that:Is not exclusively internet basedIncludes hands-on skills training provided by a certified first aid instructorRequires the individual to perform a successful demonstration of what was learned in the courseWho (in the department) receives this certification?41國家機(jī)關(guān)辦公

44、建筑和大型公共建HCA must show ODJFS evidence of training and instruction about how to deliver the HCA services that are authorized by submitting the ODJFS 2389/2390 with application packet.Training is consumer-specific and may be provided by the authorizing health care professional and/ or the consumer or t

45、he authorized representative in cooperation with the consumers authorizing health care professional.42國家機(jī)關(guān)辦公建筑和大型公共建The HCA must receive education from the authorizing health care professional about health and welfare considerations that are appropriate for an individual or group setting.43國家機(jī)關(guān)辦公建筑和

46、大型公共建HCA Services in Group Setting (Approved on a Case by Case basis only)HCAs can only provide HCA services to 2 or 3 consumers at the same residence, at the same time within the limitation noted below.Subject to approval by clinical review by ODJFS in consultation with the consumer, authorizing he

47、alth care professional, CM and the multidisciplinary team.Clinical review includes the consumers needs, and desires, and the skill level and training needs of the HCA and the ability to assure health and welfare of the consumers.44國家機(jī)關(guān)辦公建筑和大型公共建Home Care AttendantHCA service providers are limited to

48、 providing a maximum of 12 hours or forty-eight units of HCA services during a 24 hour period.Exception is made for HCA services that are provided in a group setting. 45國家機(jī)關(guān)辦公建筑和大型公共建Home Care AttendantReimbursementThis means that claims that are submitted for a single date of service that are in ex

49、cess of 48 units will be denied.46國家機(jī)關(guān)辦公建筑和大型公共建Home Care AttendantReimbursementThis does not mean that a consumer can only receive 12 hours of HCA service a day. If consumer requires more than 12 hours a day of HCA service there would need to be at least 2 shifts and 2 different service providers. 47國家機(jī)關(guān)辦公建筑和大型公共建Home Care AttendantProvider RequirementsQuestions48國家機(jī)關(guān)辦公建筑和大型公共建Home Care AttendantBilling Instructions49國家機(jī)關(guān)辦公建筑和大型公共建Home Care AttendantReimbursementNew Code S5125=Home Care Attendant Services/NursingUnit Rate=$4.17 50國家機(jī)關(guān)辦公建筑和大型公共