Elected Officials, Stakeholders and Media Relations

1. AHFSA Annual Conference Background Screening Interest Track August 4-7, 2019 Elected Officials, Stakeholders and Media Relations Jane Lengel Ohio NBCP Manager

2. Overview • Objective: Describe how the Ohio NBCP team engaged legislators, state agencies, key providers and stakeholders. • To enact legislation to correct gaps and inconsistencies in statutes and regulations. • To implement the goals and objectives of the NBCP. • Questions from interested States: Our conference goal is dialog. In this session, representatives from interested States are encouraged to ask questions; describe their challenges of effectiveness, efficiency and equity; and exchange information.

3. Background • In January 2012, Ohio created an inter-agency work team to create uniformity and eliminate gaps in the state’s system for conducting pre- and post-employment criminal background checks for direct patient access workers of HCBS providers. • The work team included SMEs from the governor’s office, attorney general’s office and representatives from six state agencies, in collaboration with key providers and stakeholder groups. • The work team effort prompted statutory changes and new regulations governing HCBS providers.

4. Background (cont.) • The work team proposed legislative changes to the General Assembly throughout 2012. • January 1, 2013, legislation was enacted. • Additional Rap Back legislation was enacted in 2014. • In April 2013, Ohio received the CMS NBCP grant. • In August 2013, Ohio conducted a Production Preparations Process (3P) event with stakeholders and key partners to define the scope and create a plan for Ohio’s NBCP project.

5. Legislation Overview House Bill 487 (ORC 173.27 and 173.394), Effective January 1, 2013 • Required HCBS providers and agencies to conduct registry checks and a criminal background check before hiring a person with direct access to patients and to conduct additional post-hiring checks every five years. • Identified uniform criteria and definitions for disqualifying offenses. • Created a decentralized process for fitness determination. • Authorized individual providers, not a state agency, to complete all registry checks, background checks and Rap Back enrollment. • Made participation in the state’s automated registry check system and enrollment in Rap Back voluntary for providers. House Bill 483, Effective July 1, 2014 • Allowed participating private employers to utilize Bureau of Criminal Identification and Investigation’s (BCI) existing “Rap Back” service. • Allowed for future expansion to other providers. • Ohio HCBS employers can now participate after their employee’s initial background check has been performed and enrolled in Rap Back. An automated notification will be sent to the employer if the employee has a new arrest or conviction.

6. Ohio’s NBCP • Received $2.8m grant from CMS for the 3-year project • Built an Automated Registry Check System (ARCS) to simultaneously perform the mandatory check of six registries • Expanded Rap Back to include HCBS providers and agencies to perform post-hiring background checks on direct patient access workers • Provided technical assistance on the use of ARCS and Rap Back • Fostered an ongoing dialogue and partnership between key state agencies, providers and stakeholder groups regarding additional ways to ensure consumer safety

7. Key Partners and Stakeholders Federal Partners: • Centers for Medicare and Medicaid Services (CMS) • CMS technical vendor: CNA Key Stakeholders, including: • Midwest Care Alliance • Ohio Association of Area Agencies on Aging • Ohio Assisted Living Association • Ohio Association of County Boards • Ohio Association of Senior Centers • Ohio Council for Home Care and Hospice • Ohio Health Care Association • Western Reserve Area Agency on Aging • Ohio Provider Resource Association (OPRA) • Home Care by Black Stone State partners: • Governor’s Office of Health Transformation (OHT) [Kasich Administration] • Ohio Department of Medicaid (ODM) • Ohio Attorney General’s Office (AGO) • Ohio Department of Administrative Services (DAS) • Ohio Department of Aging (ODA) • Ohio Department of Developmental Disabilities (DODD) • Ohio Department of Health (ODH) • Ohio Department of Mental Health & Addiction Services (OhioMHAS) • Ohio Department of Rehabilitation and Correction (ODRC) • Ohio Colleges of Medicine Government Resource Center (GRC)

8. Partners for Registry Checks • Excluded Parties List System (U.S. General Services Administration) • List of Excluded Individuals and Entities (U.S. Office of Inspector General) • Abuser Registry Verification (Ohio Department of Developmental Disabilities) • Sex Offender and Child Victim Database (Ohio Attorney General’s Office) • ODRC Inmates Database (Ohio Department of Rehabilitation and Correction) • Nurse Aide Registry (Ohio Department of Health) • Watch Systems – contract vendor to access Ohio Sex Offender Registry • Ohio Department of Administrative Services – hosting ARCS • CNA – platform design and development, upgrades, and technical advice • CMS – Grant provider and ongoing technical assistance • Ohio Department of Medicaid – provider assistance, technical support, eligibility verification, enrollment, etc. • Office of Health Transformation – grant director, leadership • Ohio Departments of Developmental Disabilities, Aging, Health, Mental Health and Addiction Services – Medicaid sister agencies with ARCS providers • Other stakeholders included providers and provider associations that participated in pilot testing for both ARCS and Rap Back

9. Lessons Learned • Communication and collaboration are critical to success • Weekly TA calls to coordinate activities and keep the project moving forward • Quarterly stakeholders/partners updates by webinar and in person • Team email and conference calls with agendas • Reach out and make new friends • Never be afraid to ask questions • Be nice and stay flexible • Have a Plan B and always stay positive and open-minded • Keep a Follow Up file and use it

10. Questions from States

11. Thank You! Jane Lengel, Ohio NBCP Manager jane.lengel@medicaid.ohio.gov 1-614-752-2051