Name: Brandy Stubnar
Title: Section Chief, Care Coordination
What is your role in the Next Generation MyCare program?
The Care Coordination Oversight and Policy section is responsible for creating care coordination guidance, training and oversight for members enrolled in MyCare Ohio and the MyCare Ohio Home and Community Based Services (HCBS) waiver. Oversight includes member case and inquiry reviews, care coordination portal reviews, and incident management reviews. This section may have regular direct contact with the MyCare Ohio Plans to provide support and feedback when member care coordination situations become complex, or escalation is required.
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What are you most excited about for the Next Generation MyCare program?
Ending the MyCare demonstration limited to members in only 29 of 88 counties and adopting a full statewide MyCare model with a strong care coordination-based foundation is exciting! Dual benefit members outside of the demonstration area who may have found coordinating benefits and providers difficult on their own, will now have access to care coordination experts through their MyCare Plan.
What is something everyone should know about you?
I have an AMAZING team with our combined backgrounds totaling more than 250 years of dedicated social service, customer service and Ohio Medicaid services experience. We are here to serve Ohioans with compassion, and person-centered principles and to support Managed Care Plans to do the same.
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Thank you for attending the Next Generation MyCare Area Agencies on Aging (AAA) Academy sessions. We hope you were able to learn about critical information on upcoming changes with the Next Generation MyCare program during these webinars. Attendees from your organization should have received the presentations from each of the below sessions.
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Part 1: Provided an overview of the Next Generation MyCare program and shared information about how you will receive communication from ODM leading up to the roll out.
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Part 2: Provided details on care coordination including introducing ODM’s Care Coordination Oversight team, going over the care coordination inquiry and incident management processes, and reviewing the AAA role in care coordination.
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Part 3: Provided an overview of the Next Generation MyCare AAA Implementation Checklist, which includes required implementation activities, guidance and timelines for the Next Generation MyCare AAA Implementation Transition Plans, and how staff can expect to receive training on Next Generation MyCare topics.
A representative from each AAA should have received a copy of the Next Generation MyCare AAA Implementation Checklist. Each AAA is responsible for completing the activities outlined in the Next Generation MyCare AAA Implementation Checklist, complete the Next Generation MyCare AAA Implementation Transition Plan template, and take part in trainings.
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The Next Generation MyCare program provides more members access to self-direction. Self-direction is a service model for Ohioans served by Medicaid waivers that gives members the support needed to stay in their homes. Self-direction helps by allowing members to choose the individual providing them with long-term services such as hep with bathing, eating, getting dressed, and more. In nursing facilities, members do not have control over who helps them or when they can get assistance. With self-direction, members have more control over their own care, such as who their providers are and when they get assistance.
A member has the option to utilize either or both of the following model options based on what makes the most sense for their situation:
Budget Authority lets members decide how to spend and distribute their money for self-directed services and supports. Through this, members can:
- Have direct oversight of how waiver funds are spent and allocated.
- Determine wages for their self-directed caregivers.
- Prioritize spending on services and supports that are most beneficial to them.
Members who choose to have budget authority over their self-directed services may to support in handling the following responsibilities:
- Negotiating and agreeing on the caregivers’ wages.
- Deciding how to allocate their funds for other self-directed services included in their person-centered service plan.
- Following program-specific rules when applicable.
- Keeping service expenses within budget limits.
Employer Authority lets members decide who they hire and how they manage their services. Through this, members can:
- Have direct oversight of their self-directed caregivers and can monitor/evaluate performance directly.
- Choose caregivers who best match their needs, preferences, and personalities.
- Ensure caregivers receive training specific to their needs.
- Set their own schedules and care routines, providing greater flexibility and control.
- Adjust their care arrangements quickly.
Members who choose to have employer authority over their self-directed services to support in handling the following responsibilities:
- Finding, hiring, and if necessary, terminating caregivers.
- Creating written agreements with caregivers that explain what is expected of them, including any trainings they need to complete.
- Training caregivers to meet specific needs and making sure this training is completed.
- Organizing caregivers’ schedules.
- Overseeing caregivers’ work.
- Approving timesheets and other necessary documents requested by ODM’s FMS vendor.
For more information on self-direction resources and training, visit the Self-Direction Resources for Care Managers page.
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