Developmental Disabilities Agencies
The clients: In Ohio, Medicaid pays for many home and community based services for developmentally disabled persons through though county Boards of Developmental Disabilities. The Ohio Revised Code outlines very specific responsibilities for the 88 County Boards of DD in Ohio, including ensuring that Medicaid Free Choice of Provider rules are followed and creating and executing Assessments and Individual Service Plans (ISPs) for all individuals served. iData works with three of the largest Ohio Counties (Cuyahoga, Stark and Summit) to automate and facilitate provider selection and ISP development.
The challenge: Cuyahoga, Stark and Summit Counties contacted iData because of significant challenges in how they were handling provider selection and Assessment and ISP development. The systems in place varied, and all presented their own challenges:
In Stark County ISPs were created in Word. No online search was possible, there was no online reporting, and notifying providers and families when ISPs changed was a manual process. Paper copies of ISPs (often approaching 100 pages in length) were mailed to providers and family members each time plans were revised.
In Summit County, IPS were created in a legacy client information system. Output was not formatted well, plan documents were very long and not designed with the needs of the person served, family or provider foremost.
Workflow was handled by updates to an Excel tickler file on a shared drive — there was no automation, no notification to the team when plans were updated, and no reporting on timelines of plan updates Compliance very difficult to ensure.
In all three counties, service referrals were manual though emails or phone calls. It was very difficult to document compliance with Medicaid free choice of provider rules. There was a worry that people served could fall through the cracks –- not finding providers in a timely manner.
The solution:iData first worked with all three counties to develop a Web-based provider search and referral portal for each county. These portal sites allowed persons needing services to find and contact providers, and the referral portion of the site allowed County Board staff to securely publish referrals for individuals needing service. Providers receive email notifications of new referrals can search published referrals for individuals that they can serve. When providers find a consumer that they can serve, they complete a contact form. Email notifications are sent of provider interest, and Board staff is able to download all responses for a given referral and review them with the person seeking services. Referrals are automatically removed from the search tool when a provider is found or when a specified time span has elapsed. The system provides workflow prompts for completing steps in creation of a referral, and provides reports of compliance with timelines set out in the Ohio Revised Code for each step of the provider selection process.
iData next worked with Summit and Stark Counties to develop an online ISP and Assessment tool with similar workflow, notification, reporting and online access features.
- User friendly screens to create ISPs and Assessments, including the ability to conditionally display data collection screens (if male, show this; if female something else), conditionally require data (if “other”, user must specify) and conditionally print (e.g. don’t print blank questions).
- Workflow – ISPs and assessments automatically forwarded for review, financial approval and distribution.
- Administrative screens allow program staff (rather than programmers) to:
- Update Assessment and ISP data collected and format as program and Medicaid requirements change. Update the text and format of data collection screens and printed output documents.
- Update workflow steps and notifications.
- Update conditional display, conditionally required fields and conditional print rules.
- Management dashboard and reports to ensure creation and updates of ISPs in line with mandatory timelines.
- Providers and families are automatically notified of new ISPs updates when they are published.
- Online access to ISPs and assessments for providers and families.
- Lower distribution costs through electronic distribution.
- An ad hoc reporting function allows program staff to answer questions based on ISP and Assessment program data (e.g. “how many persons served have diabetes by age and gender,” “what are the most common medical diagnoses in the served population”).