Ohio Admin. Code 173-39-02.20 - ODA provider certification: enhanced community living
(A)
Definitions for this rule:
(1) "Enhanced
community living" (ECL) means a service promoting aging in place, in
multi-family affordable housing, through access to on-site, individually-
tailored, health-related, and supportive interventions for individuals who have
functional deficits resulting from one or more chronic health conditions.
(a) ECL includes the following activities:
(i) The establishment of measurable health
goals.
(ii) The identification of
modifiable healthcare risks.
(iii)
The provision of regular health-status monitoring interventions. "Health-status
monitoring interventions" mean taking and recording vital signs, weight,
nutrition, and hydration statuses.
(iv) Assistance with accessing additional
allied health services.
(v) The
provision of, or arrangement for, education on self-managing chronic diseases
or chronic health conditions.
(vi)
Daily wellness checks. "Daily wellness check" means an activity of ECL through
which a PCA observes any changes in the individual's level of functioning and
determine what, if any, modifications to the activity plan are
needed.
(vii) Access to planned and
intermittent personal care under rule
173-39-02.11 of the
Administrative Code, excluding respite
care.
(viii) Activities to
assist an individual who is returning home following a hospital or nursing
facility stay.
(b) ECL
does not include activities provided while the individual is receiving a
similar service under this chapter.
(2) "Chronic health condition" means a
condition that lasts twelve months or longer and meets one or both of the
following tests:
(a) It places limitation on
self-care, independent living, and social interactions.
(b) It results in the need for ongoing
intervention with medical services, products, and equipment.
(3) "Intermittent" means stopping
and starting at intervals; pausing from time to time; periodic, not
pre-determined designated time periods (e.g., ten a.m. to eleven a.m.) or for
designated lengths of time (e.g., fifteen minutes or two hours).
(4) "Multi-family affordable housing" means a
housing site meeting all of the following requirements:
(a) The housing site uses a landlord-tenant
rental agreement that complies with Chapter 5321. of the Revised
Code.
(b) The housing site provides
a minimum of six units of housing under one roof.
(5)
"Person-centered activity" means an activity directed by the individual's
informed choices that is offered at the time and place most preferable to the
individual, in a safe and unhurried manner, and in a way that honors the
individual's individuality and preferences.
(B)
Requirements
for
Every ODA-certified
providers of ECL provider shall comply with the following
requirements:(3)(4) Staffing levels:
(4)(5) Provider
qualifications:
(a)(6)
Service verification: The
provider shall develop and retain a daily activity
record for each individual that includes all of the following
are the mandatory reporting items to include in each
individual's daily activity record: (i)(a) Individual's
name.
(ii)(b) Date of
service.
(iii)(c) Activities
provided as authorized in the person-centered activity plan.
(iv)(d)
Activities provided in response to daily, intermittent needs.
(v)(e)
Description of the individual's status and response to the activities
provided.
(vi)(f) Total number of
units provided to the individual.
(vii)(g) Name and
signature
unique
identifier of the provider's staff person who provided the activities
to attest to providing the activities.
(viii)(h)
Unique identifier of the individual, which by
offering the individual attests
to
attest to receiving the activities.
(1) General
requirements: The provider shall comply with the
requirements for every ODA-certified provider in
is subject to rule
173-39-02 of the Administrative
Code.
(2) Person-centered activity
plan:
(a) Development: Before the provider
provides the initial episode of ECL to an individual, the PCA supervisor shall
do both of the following:
(i) Assess the individual's health goals,
modifiable health risks, and planned and anticipated intermittent personal care
needs; and,
.
(ii)
Develop a person-centered activity plan with the individual that describes the
interventions the individual has chosen to reach his
or her
the individual's identified
health goals, to minimize his or her
the individual's modifiable health risks, and to
meet his or her
the
individual's planned and anticipated intermittent personal care needs.
The provider shall obtain a unique identifier of the individual to
verify
attest
that the individual was involved in the development of
his or her
the person-centered activity plan.
(b) Regular monitoring: After the
individual begins to receive ECL, the PCA supervisor shall do both of the
following:
(i) Revise the person-centered
activity plan in fewer than five days after each hospital or nursing facility
stay, and as otherwise needed to reflect changes in the individual's status,
condition, preferences, and response to ECL.
(ii) Facilitate an in-person review of the
person-centered activity plan with the individual, the primary team, the
individual's case manager, the individual's caregiver (if the individual has a
caregiver), and the housing site's service coordinator (if the housing site has
a service coordinator) every sixty days to evaluate the effectiveness of the
plan in addressing the individual's health goals, reducing modifiable risks,
and meeting planned and anticipated intermittent personal care needs.
(c) Records-retention: The provider
shall retain a record of the person-centered activity plan, including any
revisions to the person-centered activity plan and the in-person review of the
person-centered activity plan:
(3)
Primary team: The
provider shall provide person-centered activities to individuals through a
primary team that consists of PCAs and PCA supervisors who regularly provide
activities within a given housing site and, as a result, are familiar with the
individuals in the housing site.
(a) The provider shall maintain adequate
staffing levels to provide each ECL activity.
(b) The PCA supervisor shall maintain
accessibility to respond to individuals' emergencies in the housing site during
any time that a PCA is providing ECL to an individual in the housing
site.
(c) The provider shall
maintain adequate staffing levels to provide person- centered ECL seven days a
week for a minimum of six hours a day.
(d) During each hour the provider has a PCA
providing ECL to an individual in a housing site, the provider shall ensure
that any other individual has a mechanism to contact a PCA to request
assistance with intermittent and unplanned personal care needs related to the
measurable health goals and modifiable healthcare risks described in the
individual's activity plan.
(e)
Each day, the provider shall provide adequate staffing levels of on-site PCAs
for no fewer than six hours (or, twenty-four units) to meet the individuals'
assessed, intermittent, and unscheduled healthcare needs.
(f) The PCA supervisor or another RN (or LPN
under the direction of an RN) shall monitor the health status of individuals
for no fewer than three hours (or, twelve units) each week.
(g)
The provider
shall replace any PCA on the primary team who is absent with a back-up PCA who
is familiar with the housing site and the individuals residing in the housing
site. A PCA supervisor shall supervise the primary team and any back-up
PCAs.
(a) Type of provider: A
provider shall only
qualifies to provide ECL only if both of the following conditions are met:
(i) ODA certifies the provider as an agency
provider of both personal care and ECL.
(ii) The provider is a legal entity distinct
from the housing site owner and property manager so the site is not subject to
licensure, as defined in Chapters 3721. and 5119. of the Revised Code, and
safeguards are in place to prevent any unremedied conflicts of
interest.
(b) Staff
designations and minimum staff
qualifications:
(i) PCA supervisor:
The provider shall only employ a
A person qualifies to
be
as a PCA supervisor
only if the person if
the person meets the qualifications in paragraph (C)(4)(a) of rule
173-39-02.11 of the
Administrative Code.
(ii) PCAs:
The provider shall onthe qualifications under
paragraph (C)(3)(a) of rule 173-39-02.11 of thly employ a
A person qualifies
to serve as a PCA only if the person meets at
least one of e Administrative Code, the training and
competency evaluation meet the standards under paragraph (C)(3)(e) of rule
173-39-02.11 of the Administrative Code, and the provider meets the
verification requirements under paragraph (C)(3)(f) of rule 173-39-02.11 of the
Administrative Code.
(iii) Primary team: The provider
shall provide person-centered activities to individuals through a primary team
that consists of PCAs and PCA supervisors who regularly provide activities
within a given housing site and, as a result, are familiar with the individuals
in the housing site. The provider shall replace any PCA on the primary team who
is absent with a back-up PCA who is familiar with the housing site and the
individuals residing in the housing site. A PCA supervisor shall supervise the
primary team and also any back-up PCAs.
(c) Staff training:
(i)
Before
allowing any
A PCA
qualifies to have direct, in-person contact with
an individual, the provider shall comply
only after the PCA complies with the orientation
requirements in paragraphs (C)(3)(b), (C)(3)(e), and (C)(3)(f) of rule
173-39-02.11 of the
Administrative Code.
(ii)
In-service training: Each PCA shall comply
with
is subject to the in-service
training requirements in paragraphs (C)(3)(d), (C)(3)(e), and (C)(3)(f) of rule
173-39-02.11 of the
Administrative Code.
(5) Service
verification:
(b) The provider may use an
electronic system to collect or retain the records required under this
rule.
(C) Unit and rates:
(3)(2)
For the PASSPORT program,
Rule
rule
5160-31-07 of the Administrative Code establishes the rate-setting methodology
for the ECL provided through the PASSPORT program.
(1)
For the PASSPORT
program, rule
5160-1-06.1 of the
Administrative Code lists the following:
(1)(a) One unit of ECL
is
as fifteen
minutes.
(2)(b) The
appendix to rule 5160-1-06.1 of the Administrative
Code establishes the maximum rate allowable for one unit of
ECL.
Notes
Promulgated Under: 119.03
Statutory Authority: 121.07, 173.01, 173.02, 173.391, 173.52, 173.522
Rule Amplifies: 173.39, 173.391, 173.52, 173.522, 173.525; 42 CFR 441.352
Prior Effective Dates: 03/17/2011, 11/01/2017, 04/04/2022
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