COVID-19 and the provisions of HCBS services and supports

On behalf of Director Corcoran, thank you for bringing forward timely and practical questions regarding how the COVID-19 emergency may impact home and community-based service provision.  Please see responses to your specific questions below:

Q: How do we conduct supervisory visits, which are required? Can these be done virtually?  

A: Supervisory visit(s)may be conducted  telephonically if a supervisory visit is required by the waiver service.

The modified supervisory schedule must be documented in the individual’s service plan by the provider’s nurse supervisor.

The e provider shall notify the case manager if they elect to perform the supervisory visit telephonically.

Source: PCG webpage, Provider FAQ, Questions 10 and 17.

Q: Besides EVV, when will ODM give HCBS guidelines? 

A: ODM is posting updates on the PCG website at http://ohiohcbs.pcgus.com/ .   This information is updated weekly as new questions are addressed.  The attached document provides guidance to ensure safe service provision in a home or community setting.  This document will be posted to the PCG webpage in the next few days.

Q: Will ODM check on independent providers to inquiry if they are OK?

A:  Although ODM is not currently contacting independent providers (IPs) to assess their health and safety, we are exploring the feasibility of this recommendation.  IPs are encouraged to access the COVID-19 resources posted on the ODH webpage.

Q:  They do NOT have access to gloves and masks like agency provides do.

A:  Gloves and masks are covered items under the Medicaid State plan durable medical equipment benefit.  These items typically require a physician order and do not require prior authorization.  Case managers will be reminded to work with waiver participants to determine the need for these items, which independent providers can use when delivered services in the home.

Q: What is being done for consumers who have been dropped by agencies or have no coverage?

A: Waiver participants and providers are still responsible for notifying the OHCW case manager when services are unable to be delivered as authorized.  Case managers will work with individuals to activate established back up plans, identify alternative providers, or take other action to ensure the individual’s health and safety.

Q:  Can supervisors and doctors sign off on documentation without seeing the patient?

A:   Waiver providers may perform supervisory visits telephonically if a supervisory visit is required by the waiver service. (PCG webpage, Provider FAQ, Question 17. )   For state plan home health services, the face to face visit requirements may be met through the use of telehealth.  This will be clarified in the emergency home health rules. In addition, the State Medical Board has posted guidance that may be of interest.

Best Regards,

Hope L. Roberts

HCBS Policy Administrator

The Ohio Department of Medicaid

Phone: 614-752-5394

Hope.Roberts@medicaid.ohio.gov

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