protocol for fully functioning information & assistance - Western ...
protocol for fully functioning information & assistance - Western ...
protocol for fully functioning information & assistance - Western ...
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Selecting Providers<br />
Once the I&A Specialist has discussed options <strong>for</strong> services, s/he can use the resource database<br />
in ReferNET and other resource sources, including www.Medicare.gov to help the caller select<br />
providers. It is essential that the ADRC remain and be perceived as an objective, reliable, and<br />
neutral source of in<strong>for</strong>mation on services <strong>for</strong> adults with disabilities and older adults in the<br />
region. The I&A Specialist can explain to the caller that providers are included in the ReferNET<br />
database based on the Inclusion/Exclusion Policy and the Conflict of Interest Policy and that it is<br />
imperative that the caller evaluate each provider and make the final selection. S/he may also<br />
go to (or refer a caller to) www.Medicare.gov <strong>for</strong> quality indicators on hospitals, nursing<br />
facilities, and home health agencies and provide that in<strong>for</strong>mation to the caller. In addition, a<br />
referral can be made to the Long Term Care Ombudsman (LTCO) program so the caller can<br />
obtain complaint in<strong>for</strong>mation as they make their provider selection.<br />
It should be noted that not all individuals needing <strong>assistance</strong> in locating hands-on or chore<br />
service providers want or need to work with a home health agency or other <strong>for</strong>mal caregiving<br />
providers. Some Ohio Medicaid Waivers have provisions whereby individuals can hire and<br />
manage their own providers. Others are not Medicaid eligible or are able to pay privately <strong>for</strong><br />
these services. There is not one central repository <strong>for</strong> lists of independent providers although<br />
the Ohio Department of Job and Family Services (ODJFS) does maintain a state-wide provider<br />
list of non-agency independent contractors on its website:<br />
https://portal.ohmits.com/Public/Public%20In<strong>for</strong>mation/Search%20Provider%20Directory/tabId/61/Defau<br />
lt.aspx ADRC staff may call LEAP at this point <strong>for</strong> <strong>assistance</strong> in identifying independent providers<br />
and other supports to meet the individual’s needs.<br />
Selection of providers should be based on the in<strong>for</strong>mation gathered during Discovery and the<br />
Service Education/Identification processes. Selection criteria can include: location near<br />
consumer or caregiver’s home; near caregiver’s place of employment; cost; amenities; religious<br />
or cultural background; whether there is a provider waiting list; scope of available services; etc.<br />
The I&A Specialist should reassure the caller that s/he can mail written in<strong>for</strong>mation to support<br />
the discussion. S/he should also assess the capacity of the caller to handle referrals <strong>for</strong> multiple<br />
services/providers and prioritize needs. The process can be sequenced over several steps to<br />
ensure the caller is linked to the most essential service(s) first.<br />
ReferNET should be used to track referrals and feedback on experience of the caller that can be<br />
gained in follow-up contacts.<br />
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