Rule 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.
(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.
(c) The housing site receives assistance through one of the following programs:
(i) Federally-assisted housing program under 24 C.F.R. Part 5.
(ii) Project-based voucher program under 24 C.F.R. Part 983.
(iii) Low-income housing tax credit program based on Section 42 of the Internal Revenue Code.
(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 ODA-certified providers of ECL:
(1) General requirements: The provider 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.
(ii) Develop a person-centered activity plan with the individual that describes the interventions the individual has chosen to reach the individual's identified health goals, to minimize the individual's modifiable health risks, and to meet the individual's planned and anticipated intermittent personal care needs. The provider shall obtain a unique identifier of the individual to attest that the individual was involved in the development of 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.
(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.
(4) Staffing levels:
(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.
(5) Provider qualifications:
(a) Type of provider: A provider 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 qualifications:
(i) PCA supervisor: A person qualifies to be a PCA supervisor only if the person meets the qualifications in paragraph (C)(4)(a) of rule 173-39-02.11 of the Administrative Code.
(ii) PCAs: A person qualifies to serve as a PCA only if the person meets at least one of the qualifications under paragraph (C)(3)(a) of rule 173-39-02.11 of the Administrative Code.
(c) Staff training:
(i) A PCA qualifies to have direct, in-person contact with an individual 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 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.
(6) Service verification: The following are the mandatory reporting items to include in each individual's daily activity record:
(a) Individual's name.
(b) Date of service.
(c) Activities provided as authorized in the person-centered activity plan.
(d) Activities provided in response to daily, intermittent needs.
(e) Description of the individual's status and response to the activities provided.
(f) Total number of units provided to the individual.
(g) Name and unique identifier of the provider's staff person who provided the activities to attest to providing the activities.
(h) Unique identifier of the individual, to attest to receiving the activities.
(C) Unit and rates:
(1) For the PASSPORT program, rule 5160-1-06.1 of the Administrative Code lists the following:
(a) One unit of ECL as fifteen minutes.
(b) The maximum rate allowable for one unit of ECL.
(2) For the PASSPORT program, rule 5160-31-07 of the Administrative Code establishes the rate-setting methodology for ECL.
Last updated July 2, 2024 at 9:55 AM
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