Frequently Asked Questions


What are the qualifications to become a Care Manager?

Health Home Care Managers who serve adults and children with intellectual and developmental disabilities must meet at least one of the following qualifications:

  • Bachelor of Arts or Science degree with two years of relevant experience
  • Licensed as a registered nurse with two years or relevant experience
  • Master’s degree with one year of relevant experience

 

What if I decide not to become a Health Home Care Manager?

All future service coordination will be provided by Health Home Care Managers. This new job opportunity offers the chance for career growth and more rewarding outcomes for you and the people you support. No matter what your career plans, all current Medicaid Service Coordinators will play a key role in ensuring that individuals and families continue to receive uninterrupted service during the transition to CCOs.

 

Why is OPWDD switching from Medicaid Service Coordination to Health Home Care Management?

Health Home Care Management is an improved type of service coordination that will better support people, including those with complex needs. It will allow for better information sharing, resulting in more flexible and comprehensive service planning.

 

When will the transition to Health Home Care Management take effect?

CCOs will begin providing Health Home Care Management services on July 1, 2018.

 

Is Health Home Care Management a form of Managed Care?

No, Health Home Care Management should not be confused with Managed Care. Managed Care will take several years to develop in the OPWDD system and will be offered at a future date.

 

How will the CCOs work with the Front Door process?

Front Door will continue to be the means by which OPWDD connects people to the services they need and want by determining OPWDD eligibility and referring eligible individuals to CCOs for Care Management services. Health Home Care Managers will work with individuals and their advocates to request OPWDD service authorization through OPWDD Regional Offices.

 

How often will someone receiving Health Home Care Management be seen face-to-face?

For individuals who are transitioning from Service Coordination to Health Home Care Management, the enrollment process will include a review of the current services in place and an evaluation of any possible immediate needs. This review will be documented on a checklist and will serve as the initial onboarding meeting and the Care Plan “addendum,” while the new Life Plan is developed using person-centered processes. It is expected that a Life Plan will be completed by the person’s next annual review date, keeping people on the same review cycle unless they have a particular need for a review (change in condition) or request a planning meeting. A face-to-face person-centered planning review must also take place at least once every year, and all members of the interdisciplinary team must participate.

In addition to the monthly documentation of at least one Health Home core service, Care Managers must adhere to the following face-to-face meeting requirements:

  • The Health Home Care Manager must have at least one face-to-face meeting with individuals receiving Tier 1, 2 or 3 level of supports on a quarterly basis (January-March, April-June, July-August and September-December).
  • The Care Manager must have monthly face-to-face meetings with individuals receiving Tier 4 level of supports.

 

What is a Life Plan?

The Life Plan will replace the Individualized Service Plan (ISP). It will be reviewed routinely and updated as needed based on each individual’s goals and changing needs. As a Care Manager, you will work with each individual to create a plan based on their wants and needs. Each Life Plan will include coordination of developmental disability related supports and other services, like medical, dental and mental health.