Submitted by achenault on Wed, 03/25/2015 – 5:29pm
The outcry over the Kasich administration’s proposed “elimination of Independent Providers (IPs)” has led finally to clarification, by the Ohio Office of Health Transformation, that their proposal “does not eliminate independent providers.”
In February 2015, OHT announced that the budget “requires Medicaid to eliminate the ‘independent service provider’ option” as a means to “decrease programmatic fraud and abuse.” This announcement sent shockwaves through the disabilities, developmental disabilities and aging communities, especially among individuals and families relying on IPs for home care. For two weeks in March, the House Finance Subcommittee on Health & Human Services heard testimony from individuals and family members opposing theproposal. Many recounted their bad experiences using an agency and expressed their desire to maintain their choice of who provides their most intimate care – such as dressing, feeding, bathing, and toileting. In his testimony, John Lepley, MyCare Ohio enrollee and OCVIC Central Region member co-chair, said, “The Independent Provider program allowed me to find excellent quality home health aides who were loyal to me and not to an agency. No longer did I have to worry if my aide was going to show up on time — or show up at all, for that matter. As a student at The Ohio State University, this was instrumental in allowing me to attend classes and eventually graduate with my Bachelor’s degree.” (Testimony can be found on the House Finance: Health & Human Services Subcommittee’s website under March 18.)
However, despite OHT’s announcement, their proposal did not eliminate IP services, but rather make changes to comply with federal labor rules and expand Ohio’s “self-direction” program. Self direction allows the consumer to act as the employer – recruit, hire, schedule, supervise and discharge their chosen home care providers. A financial management company is available to handle payroll, time sheets, paying workers’ compensation, and other administrative functions.
UHCAN Ohio and Ohio Consumer Voice for Integrated Care leaders learned from national experts that Ohio faced possible liability in its current system of reimbursing IPs as if they were contractors of services, when under federal law, they should be classified as employees. For that reason, OCVIC manager John Arnold asked the subcommittee:
On March 24, OHT hosted a stakeholder meeting at which they shared their goals for expanding self direction in Ohio’s Medicaid HCBS programs: Increase access to home and community based services, make self-direction an option in every HCBS waiver program, comply with federal fair labor standards, and improve quality of in-home direct care. The state agreed that the budget language, including transition timetable would change, and that a workgroup will be created to work out details of the transition.
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OCVIC’s other Budget Testimony
In testimony, OCVIC’s Project Manager had three other budget recommendations to help MyCare Ohio Consumers:
OCVIC coalition members are hopeful that, with these important funding additions, MyCare consumers will experience a smoother transition to receiving their acute care and long-term services and supports from Managed Care Organizations; that enrollees will have better health outcomes; and that Medicaid budget growth will be constrained.