Section 5124.24 | Determination of per medicaid day quality incentive payment.
(A) For fiscal year 2021 and each fiscal year thereafter, the department of developmental disabilities shall determine in accordance with division (C) of this section a per medicaid day quality incentive payment for each ICF/IID that earns for the fiscal year at least one point under division (B) of this section.
(B) Each fiscal year beginning with fiscal year 2021, the department, in accordance with rules authorized by this section, shall award to an ICF/IID points for the following quality indicators the ICF/IID meets for the fiscal year:
(1) The ICF/IID created and promoted diverse opportunities for its residents to participate in the broader community in the applicable cost report year.
(2) The ICF/IID offers its residents multiple opportunities for off-site day programming activities, including resident-specific activities.
(3) All of the ICF/IID's residents who are least eighteen years of age and interested in employment have an identified place on the path to community employment specified in rules adopted under section 5123.022 of the Revised Code.
(4) The ICF/IID has an active advocacy group that is driven by its residents or fosters its residents' participation in a community-wide group.
(5) The ICF/IID meets both of the following standards:
(a) The ICF/IID's bedrooms are designed and arranged to enhance privacy, promote personalization, and meet its residents' needs ;.
(b) The ICF/IID encourages residents to bring to the ICF/IID their own home and room decor.
(6) The ICF/IID has and follows a policy specifying how it seeks direction from its residents.
(7) The ICF/IID has a policy for doing both of the following:
(a) Evaluating each hospital emergency department visit by its residents to identify precipitating factors that led to the visit;
(b) Developing a plan to mitigate any identified precipitating factors.
(8) The ICF/IID has adopted the recommendations for resident health screenings that the department publishes on its web site.
(9) Each month, the ICF/IID offers at least the number of wellness and fitness activities specified for this purpose in rules authorized by this section.
(10) The number of the ICF/IID's staff who were trained in positive behavior support strategies, trauma-informed care, and similar topics in the applicable cost report year is at least the number specified for this purpose in rules authorized by this section.
(11) Members of the ICF/IID's staff are involved in orienting and mentoring new staff.
(12) The ICF/IID's ratio of direct care staff to residents is at least the ratio specified for this purpose in rules authorized by this section.
(13) The ICF/IID's direct care staff retention percentage is at least the percentage specified for this purpose in rules authorized by this section.
(C) An ICF/IID's per medicaid day quality incentive payment for a fiscal year shall be the product of the following:
(1) The relative weight point value for the fiscal year as determined under division (D) of this section;
(2) The number of points the ICF/IID was awarded under division (C) of this section for the fiscal year.
(D) The relative weight point value for a fiscal year shall be determined as follows:
(1) For each ICF/IID, determine the product of the following:
(a) The number of inpatient days the ICF/IID had for the applicable cost report year;
(b) The number of points the ICF/IID was awarded under division (C) of this section for the fiscal year.
(2) Determine the sum of all of the products determined under division (D)(1) of this section for the fiscal year;
(3) Determine the amount equal to three and fourhundredths per cent of the total desk-reviewed, actual, allowable direct care costs of all ICFs/IID for the applicable cost report year;
(4) Divide the amount determined under division (D)(3) of this section by the sum determined under division (D)(2) of this section.
(E) The director of developmental disabilities shall adopt rules under section 5124.03 of the Revised Code as necessary to implement this section, including rules that specify or establish all of the following:
(1) The data needed for the department to determine whether an ICF/IID meets the quality indicators specified in division (B) of this section, the medium through which a report of the data is to be submitted to the department, and the date by which the report of the data must be submitted to the department;
(2) Satisfactory evidence needed to determine that an ICF/IID has met the quality indicators;
(3) The method by which ICFs/IID are to be awarded points under division (B) of this section and the number of points that each quality indicator is worth based on the quality indicator's relative importance compared to the other quality indicators.
Available Versions of this Section
- July 1, 2018 – Enacted by House Bill 24 - 132nd General Assembly [ View July 1, 2018 Version ]
- October 17, 2019 – Amended by House Bill 166 - 133rd General Assembly [ View October 17, 2019 Version ]