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Serving County
Boards of MRDD: Belmont, Carroll,
Coshocton, Fairfield, Guernsey,
Harrison, Hocking, Holmes, Jefferson,
Knox, Licking, Monroe, Morgan,
Muskingum, Noble, Perry, Tuscarawas &
Washington
MEORC Comprehensive Directory of
Products
Table of Contents
Introduction to
Mid East Ohio Regional Council of
Government (MEORC)
MEORC Mission
Statement and Goals
MEORC
Products Defined
MEORC New
Product Development Process
Business
Products
Authorized
Representative Payee
Billing
Services
Legal Fund
Payment
Processing
Special
Enterprise Investment Fund
Waiver
Management
Quality
Products
Accreditation
Readiness
Medication
Administration & HRA Training and
Certification
Nursing
Quality Assessment Review
Provider Compliance Review
Quality Assurance Review
Quality Service System
Investigative Services Products
Office
of Investigative Services
Pricing
Introduction
We are pleased to present the Mid-East
Ohio Regional Council of Government
(MEORC) Product Directory for
publication to our customers. The MEORC
Product Directory is an important
document that describes how we strive to
accomplish our mission:
“MEORC EXISTS TO IMPROVE THE QUALITY OF
LIFE FOR INDIVIDUALS WITH DISABILITIES”.
Our customers include eighteen county
boards of mental retardation and
developmental disabilities in
southeastern Ohio located in Belmont,
Carroll, Coshocton, Fairfield, Guernsey,
Harrison, Hocking, Holmes, Jefferson,
Knox, Licking, Monroe, Morgan,
Muskingum, Noble, Perry, Tuscarawas and
Washington counties. Our Board of
Directors is representative of the
Superintendents of these eighteen
boards. They provide the leadership and
direction for our agency to accomplish
its mission. The Product Directory
defines concepts of core products,
bundling, value-added benefits and a la
carte participation for our customers.
The directory also describes the process
used for new product development. Most
importantly, the directory includes an
exhaustive list and description of the
diverse array of services and products
we provide to our customer county boards
that ultimately improve the lives of
individuals with disabilities.
As part of our dedication to quality
systems we update our MEORC Product
Directory annually, reflecting a
commitment to improving our products and
adding new ones that help us better meet
our customers needs each day.
Please contact us at Mt. Vernon
740-397-4733 or Cambridge 740-439-9888
if you have any questions or comments.
Also, please visit our website at
www.MEORC.com to learn more about MEORC
and our county boards.
Thanks for your interest in MEORC and we
welcome your feedback on how we can
better serve you.
Our Mission:
MEORC EXISTS TO IMPROVE THE QUALITY OF
LIFE FOR INDIVIDUALS WITH DISABILITIES
Our Vision: Our Goals:
Goal 1: MEORC County Boards will obtain
the highest possible outcomes as
measured by external review processes.
Goal 2: MEORC will be a highly efficient
and effective quality-driven agency as
measured by performance excellence
criteria.
Goal 3: All stakeholders will value
MEORC products as measured by
stakeholder satisfaction surveys.
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MEORC
Products Defined
I. MEORC Core Products
Core Products - Core products
are those products that a segment of
MEORC members have elected to support
through shared funding and/or in-kind
contribution to recover the MEORC cost
to provide the product. The parameters
of core services are distinct and
defined in the comprehensive description
in the service directory. The parameters
of each core service enable the actual
“shared cost” of the product to be
identified for purposes of developing a
cost proposal and ultimately the fair
share for contributing members.
II. Value Added Benefits
Value Added Benefits - Nearly
all core products provided at MEORC have
defined value added benefits for those
members purchasing them. These benefits
are described in the comprehensive
product description. Value added
benefits are those benefits that add
value beyond what may normally be
expected from a vendor meeting the
minimum requirements of a needed
product.
III. Bundled Core Products
Bundled Core Products -
Occasionally core products are bundled
into a “package” of like services that
results in additional savings for
participants.
IV. A la Carte Participation
A la Carte Participation - A
customer of MEORC purchases a core
product without purchasing a larger
“bundled package” of services. A la
Carte participation is always paid at a
premium by the member needing the
product. A premium is paid to ensure
that the existing contributing members
who are purchasing “packaged” or
“bundled” core products will not be
negatively impacted by a separate a la
carte purchase. A la Carte participation
is also appropriate when a member has a
need for a portion of the core product
but not all the fully described features
of the core product. Typically the
parameters of this type of a la carte
participation are outlined in an agreed
to statement of work.
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MEORC New Product Development
Process
Step 1. Idea stage -
MEORC members identify a potential new
service idea for outsourcing or meeting
a mandate.
Step 2. Prototype Stage
- A description of the new product idea
is developed by MEORC assigned staff.
This description provides enough detail
to enable a member to decide if they are
interested in the new product.
Step 3. Interest Survey
- MEORC conducts a survey to all members
seeking either definite interest in the
product or potential interest in the
product with questions. The survey may
be conducted via web-based survey tools
(i.e. surveymonkey.com). Those members
that may be interested are contacted to
answer any questions they may have
related to the potential product.
Additional comments from the survey will
also be included in design elements of
the product.
Step 4. Level of Need Inquiry
- What is the level of need among the
interested members? This stage attempts
to quantify the potential needs of
interested members in order to determine
the level of resources necessary to
provide the product.
Step 5. Development of Statement
of Work - In concert with the
interested members, the product is
designed. Details related to what the
product looks like, how it is provided,
parameters and scope of the product are
codified into a statement of work.
Step 6. Shared cost proposal
- Based on the statement of work and
final draft product design, the cost of
the new product is established. The
total cost of the product is shared
among the interested members using a
fair and equitable methodology based on
each member’s usage of the product. Unit
of measure decisions on how the product
is purchased will be made at this step
(i.e. per instance of service, annual
payment, etc.).
Step 7. Decision to present for
approval, redesign, or abort -
The interested members will analyze the
final product and shared cost to make a
decision of whether this is a viable
product that MEORC can provide at a cost
that is pragmatic for the members. At
this point redesign may be an option in
order to lessen cost by changing some
elements of product design. The idea may
be aborted if it is determined to be too
costly or not feasible to provide the
product through utilization of MEORC.
Step 8. Interest Re-survey
- If the decision is made to proceed
with presentation of the product design
to the MEORC Board for approval, members
are re-surveyed to determine if there is
any additional interest in the product
by other member counties. If additional
members indicate an interest in the
product, the shared cost proposal may
require revision.
Step 9. Approval and inclusion
in the MEORC Services Directory
- The new product and cost proposal will
be presented to the full MEORC Board for
consideration. If approved, the new
product is included in the MEORC
services directory as an available
product for members.
Step 10. Analysis of Product
- Annually all products are reviewed to
determine if they must be changed,
expanded or eliminated. The MEORC
services directory will reflect any
changes in the product and/or
description.
Definitions:
Members mean any County Board
of MRDD in Region V that is in good
standing as a participating member of
MEORC.
Product means any service,
product, initiative that is available to
members of MEORC under the concept of
“shared cost.”
Shared Cost means a methodology of
fair and equitable sharing of cost of
product purchased from MEORC by members.
Unit of Measure means the base unit
by which a product cost is determined or
is purchased.
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Business Products
Authorized Representative Payee
Core Product:
Authorized Representative Payee
• Approved as an Authorized
Representative Payee through the Social
Security Administration
Value Added Benefits: Authorized
Representative Payee Benefits
• Stability of Income for Individuals
• Help Protect from Financial
Exploitation and Abuse
AUTHORIZED REPRESENTATIVE PAYEE
– COMPREHENSIVE PRODUCT DESCRIPTION:
CORE PRODUCT / AUTHORIZED REPRESENTATIVE
PAYEE:
The Authorized Representative Payee
Service is designed to help adults with
Mental Retardation and Developmental
Disabilities who receive Social Security
benefits to pay their bills; to meet
basic living needs and all personal
financial obligations. As described by
the Social Security Administration, an
Authorized Representative Payee is an
individual or organization that receives
Social Security payments for someone who
cannot manage or direct someone else to
manage his or her money.
Authorized Representative Payee
The main responsibility of an Authorized
Representative Payee is to use the
Social Security funds to pay for the
current and foreseeable needs of the
individual. Qualifying individuals are
referred by the county board and enroll
in this service. As the Authorized
Representative Payee, MEORC receives the
Social Security checks directly and
ensures that basic needs such as rent,
utilities, food and clothing are paid as
a priority. Individuals are then
assisted to designate spending money for
other items. This service will not
involve providing skill development
plans or developing money skills.
VALUE ADDED BENEFITS /
AUTHORIZED REPRESENTATIVE PAYEE
BENEFITS:
Stability of Income for Individuals
Provides assurance that rent, food, and
other necessary expenses will be paid
regularly. Improves individuals’ credit
and prevents late fees or duplication of
services.
Provides opportunity for increased
savings for larger, special purchases.
Ensures that financial entitlements do
not lapse, and that money is spent
appropriately. Increases the chance of
achieving future life goals, such as
sustained independent living.
Help to Protect from Financial
Exploitation and Abuse
MEORC participates in the following
reviews with the Social Security
Administration:
(1) 6- month site visits, (2) Site
reviews-at least once every 3 years, (3)
Face-to-face interviews and
(4) Sample random records reviews.
MEORC will provide to participating
members, guardians when applicable, and
County Boards an accounting record of
activities on a routine basis.
MEORC will be responsible to notify the
Social Security Administration and the
local Department of Job and Family
Service office of changes in fiscal
circumstances.
When individuals require annual income
tax filing MEORC will complete the
Internal Revenue Service (IRS) forms.
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Billing Services
Core Product:
Billing Uploads to ODMRDD
• Day Habilitation
• Targeted Case Management (TCM)
Value Added
Benefits
• Technical Assistance
• Training
• Liaison Functions
• Quality Outcomes and Statistical
Analysis
BILLING SERVICES
– COMPREHENSIVE PRODUCT DESCRIPTION:
CORE PRODUCT / BILLING UP-LOADS TO
ODRMDD:
On an as needed or requested basis,
MEORC will provide, through the member
collaborative database, upload billing
functions for county board direct
services.
Day Habilitation
MEORC creates billing files based on
electronic or hard copy documentation
submitted by the member and validates
billing files through use of the
collaborative database software. MEORC
works with the billing contact person
from the county board to resolve
documentation questions and invalid
billing records. MEORC will upload all
properly documented and validated
billing files to the, ODMRDD web based,
Medicaid Billing System. ODMRDD payments
are made directly to the county boards.
Targeted Case
Management (TCM)
MEORC creates billing files based on
electronic or hard copy documentation,
submitted by the member and validates
the billing files through use of the
collaborative database software. MEORC
works with the billing contact person
from the county board to resolve
documentation questions and invalid
billing records. MEORC uploads all
properly documented and validated
billing files to the, ODMRDD web based,
Medicaid Billing System. ODMRDD payments
are made directly to the county boards.
VALUE ADDED BENEFITS:
Technical Assistance
Stakeholders receive the benefits of
MEORC staff specialization and expertise
through assistance in regards to diverse
perspectives of other members.
Availability of technical assistance is
on a daily basis. Stakeholders receive
updated information regarding changes
that occur in the system and assistance
in making changes in processes in
accordance with mandates.
Training
MEORC coordinates and conducts training
in to assist members to connect with
neighboring county boards to share
information in regarding successful
procedures. MEORC coordinates and
conducts training to assist members with
successful administration of billed
services.
Liaison
With current participation of members,
MEORC represents over 20% of the 88
counties in the State which provides a
combined voice to assist with change at
the State level.
MEORC, as an entity, is involved with 18
County Boards with varying opportunities
and resources. Through this long-term
involvement with County Boards, MEORC is
able to share diverse options and
perspectives.
MEORC leadership staff serves as
representatives on State level
workgroups.
MEORC communicates on behalf of the
membership with providers, ODMRDD, ODJFS
and OACBMRDD.
Quality Outcomes and Statistical
Analysis
Provides routine updated information and
statistical analysis, via a
collaborative database system, related
to county board billed services to
assist stakeholders with the monitoring
and measuring of outcomes based services
and the improvement of the delivery of
services.
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Legal Fund
Core Product: Legal Fund
Products
• Access to Legal Services
Value Added Benefits:
• Liaison
LEGAL FUND – COMPREHENSIVE
PRODUCT DESCRIPTION: CORE PRODUCT /
LEGAL FUND: MEORC works
collaboratively with stakeholders to
ensure compliance with rules and
regulations that pertain to the core,
bundled or a la carte products purchased
by stakeholders.
Access to Legal Services
Stakeholders receive the benefit of
legal services to address common issues
facing the industry.
VALUE ADDED BENEFITS:
Liaison
MEORC develops successful and positive
relationship with contracted legal
counsel and, in many instances, serves
as liaison for stakeholders.
MEORC communicates with member county
boards regarding interactions with legal
professionals and any predicted impact
on the local delivery system.
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Payment Processing
Core Product: Payment Processing
• Complete Payment Cycles for Non-Waiver
Funds
• Contract Development and Management
Value Added Benefits:
• Liaison
• Staff Specialization and Expertise
• Specialized Debit Card System
• Supporting Documentation
• Voucher Preparation
• Vendor Communications
• W-9s and 1099s
• File Management
• Accountant Communications
• Documentation Reviews
PAYMENT PROCESSING –
COMPERHENSIVE PRODUCT DESCRIPTION:
CORE PRODUCT / PAYMENT OF
NON-WAIVER FUNDS:
MEORC processes payment of supported
living allocations in accordance with
5123:2- 12-04 and 5126.40 to 5126.45. In
addition, MEORC processes payment of
other state and local funding as
authorized by the members.
Distribute Funds
MEORC distributes funds provided by or
on behalf of County Boards, in
accordance with ISPs, for: Supported
Living, Homemaker Personal Care,
Non-waiver subsidies, Room and Board in
licensed setting, one time or General
Revenue Funds. MEORC mails checks and
remittance advices for the payments
processed under this description. MEORC
maintains a tax exemption certificate.
Contract Development and
Management
MEORC staff members prepare Supported
Living, Non-Waiver contracts and
addendums based on ISPs, negotiations or
other relevant information. MEORC
maintains a systematic process for
mailing, tracking and distribution of
prepared contracts to providers. The
systematic process ensures proper
contract signatures and coordination
with payments. MEORC efficiently and
effectively communicates contract
attachments by way the agency web site.
VALUE ADDED BENEFITS:
Liaison
MEORC staff members communicate on
behalf of the member counties with:
providers, vendors, individuals,
families, guardians, ODMRDD, ODJFS and
OACBMRDD.
Staff Specialization and
Expertise
MEORC fiscal staff focuses on providing
professional, quality and consistent
service to member counties. This
specific focus on fiscal functions
results in specialization and enhanced
expertise in the financial arena.
Specialized Debit Card System
MEORC establishes specialized debit
cards in accordance with ISPs.
Specialized debit cards are available
for cost of living subsidies, as
identified in the ISPs. The debit cards
have specialized restrictions on usage
and dollar limitations.
Supporting Documentation
MEORC is responsible for the maintenance
of supporting documents on all payments
processed under this product
description.
Voucher Preparation
MEORC prepares and distributes vouchers
to members, providers, vendors or
individuals, as applicable, for approval
of purchases prior to payment.
Vendor Communications
MEORC works with vendors (providers and
merchants) to coordinate payments and to
settle any payment issues that may
arise.
W-9s and 1099s
MEORC gathers W-9s from vendors for tax
identification purposes. MEORC contracts
with an outside accounting firm to
prepare the year-end 1099’s. As
required, MEORC annually distributes
1099s to vendors.
File Management
MEORC manages files to ensure timely
availability of payment and invoice data
and compliance with governmental
auditing standards.
Accountant Communications
MEORC transfers fiscal data monthly to
an outside contractor accounting firm.
MEORC communicates effectively with the
accounting firm to ensure accurate and
timely preparation of financial
statements.
Documentation Reviews
MEORC conducts monthly random reviews of
Supported Living provider documentation
to ensure that payment for services is
in accordance with documentation of
services.
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Special Enterprise Investment
Fund
Core Product: Special Enterprise
Investments
• Investment Services
Value Added Benefits:
• Interest Retention
SPECIAL ENTERPRISE INVESTMENT
FUND – COMPREHENSIVE PRODUCT
DESCRIPTION:
CORE PRODUCT/SPECIAL ENTERPRISE
INVESTMENTS:
MEORC establishes investments on behalf
of member boards to enhance the
authorization by ORC 5126.05 of county
boards to coordinate, monitor, and
evaluate existing services and
facilities available to individuals.
Member boards pursuant to various ORC
sections have responsibilities and
authority concerning the development of
supported living, and other services.
Investment Services
MEORC invests county board funds in
accordance with MEORC policies and
applicable laws. Minimum participation
is $10,000.00 for the initial
establishment of the enterprise
investment. Interest earnings on such
investments are available for use at the
discretion of the member board. MEORC
provides investment status reports to
members. MEORC will work with Merrill
Lynch to invest within parameters of
public funds laws.
MEORC employs a certified public funds
investment manager as required for
current investment opportunities.
VALUE ADDED BENEFITS:
Interest Retention
Enterprise funds provided by a member
board, including any interest earned on
such funds, shall be obligated and
expended by MEORC with the prior
approval of that member board.
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Waiver Management (See Diagram
#1)
Core Product: Waiver Management
• Packet Review
• ISP Fiscal Analysis
• PAWS Development
• PAWS Upload to ODMRDD
• Utilization Review
Value Added Benefits:
• File Management
• Provider Selection Assistance
• Technology Support
• Website Updates
• Countywide Fiscal Analysis
• Patient Liability Administration
• External Reviewers
• Policy and Procedure Development
• County Contact Meetings
• Liaison
• Training and Technical Assistance
WAIVER MANAGEMENT -
COMPREHENSIVE PRODUCT DESCRIPTION:
CORE PRODUCT/WAIVER MANAGEMENT CYCLE:
MEORC implements a system of waiver
management services to assist member
boards with the administration and
coordination of Medicaid local
administrative authority in accordance
with 5126.05.5 (ORC).
Packet Review
MEORC staff members conduct external
quality reviews of every referral packet
submitted by member boards. MEORC staff
members work with member board staff to
resolve issues uncovered during the
packet review. This quality review
ensures consistency of assessments,
plans and service levels, as well as,
compliance with rules and regulations.
Upon completion of the review on
referral packets, MEORC staff members
submit, track and monitor the required
documents to ODMRDD for eligibility
processing.
ISP Fiscal Analysis
MEORC staff members conduct external
fiscal analysis on every referral packet
submitted by member boards. MEORC staff
members work with member board staff to
resolve issues uncovered during the
fiscal analysis. The fiscal review
ensures ISP service levels, cost
information and Payment for
Authorization of Waivers Services
(PAWS), as well as, compliance with
rules and regulations. Upon completion
of the fiscal analysis on referral
packets, MEORC staff members communicate
with certified providers to confirm
rates, service levels (i.e. ratios), and
terms of service contracts.
PAWS Development
MEORC staff members perform data entry
of PAWS for referral packets submitted
by member boards. MEORC prepares PAWS
and notification of change in status
forms (NICS), to ODMRDD and as
applicable ODJFS, when the following
circumstances affect individual
services: (a) suspension of waiver
services due to institutionalization,
(b) change of address, (c) change in
waiver type and (d) transfer out of
county.
PAWS Management
MEORC staff members submit PAWS to
ODMRDD for referral packets from member
boards. MEORC staff members coordinate
and track the receipt of PAWS
confirmations from ODMRDD. In accordance
with rules and regulations requirements,
MEORC maintains a routine and systematic
approach for tracking, preparing and
distributing of PAWS confirmations to
providers and individuals receiving
services.
MEORC maintains a routine and systematic
approach to ensure consistency between
ODMRDD confirmations and PAWS
submissions.
MEORC serves as the waiver contact for
member boards in relations with the PAWS
and waiver units at ODMRDD. Aligned with
this function are the follow-up,
communication and analysis of PAWS
issues and discrepancies to ensure the
expedited processing of PAWS for
individual receiving services.
Utilization Review
MEORC reviews utilization reports from
the database and alerts SSA of
discrepancies. This review does not
involve an examination of provider
documentation. The reviews are conducted
through the use of the collaborative
member boards and MEORC database. The
technology review process compares
units, rates and ratios billed to ISP
authorized services. MEORC coordinates
Gatekeeper training, initial and
ongoing, for SSAs relative to printing
utilization reports and interpretation
of reports. MEORC imports waiver
provider billing information from the
ODMRDD on-line Medicaid billing system.
MEORC updates the utilization details
from waiver providers in the
collaborative database for easy access
from member board locations.
VALUE ADDED BENEFITS:
File Management
MEORC maintains case files, provider
files and fiscal files for member
boards. The file development and
maintenance is coordinated by MEORC in
order to retain supporting documents for
external review of member boards.
Provider Selection Assistance
MEORC communicates with member board
staff to coordinate provider selection
needs upon receipt of non-renewal
contract notices from the providers or
the individuals that are receiving
services. When requested, MEORC updates
the individual profile section of the
agency web site to solicit needed
providers.
Technology Support
MEORC reviews and grants access to
OhioMRDD.com which is a communication
vehicle for the service providers and
the individuals that receive services.
Upon request, MEORC reviews and grants
security to the collaborative database
applications for member boards.
MEORC maintains aspects of the
collaborative database of vendors,
member board staffs and service
providers. In order to facilitate a
current and accurate collaborative
database, MEORC monitors replication
between county boards and MEORC.
The consistent integration of member
board and MEORC information is a core
value that drives the need for effective
technology. MEORC maintains financial
responsibility for the annual database
license agreement for residential
modules of the collaborative database
software.
MEORC utilizes technology for surveying
as a method to ensure timely
coordination of meetings, services, new
product developments and feedback loops.
MEORC utilizes and is financially
responsible for a conference line that
facilitates effective and efficient
alternatives for meetings.
Web site Updates MEORC
develops and maintains an agency web
site to facilitate information sharing
among stakeholders. The following areas
are updated as necessary to ensure the
availability of timely information:
announcements and notices of trainings,
meetings; Frequently Asked Questions
(FAQs); relevant information for
individuals, guardians, and families;
County Board links; and ODMRDD and other
agency links.
Countywide Fiscal Analysis
MEORC successfully ensures compliance
with audit (Federal and State)
requirements. MEORC verifies the receipt
and deposits of funds received on behalf
of county boards. MEORC assists member
boards in the accurate tracking of
residential funding allocations. MEORC
assists member boards in assuring the
accurate calculation of match funds for
waiver services and local commitment
analysis. The development and
maintenance of residential projections
aligns with this function.
MEORC contracts with an external CPA
firm to ensure the effectiveness of
internal controls.
MEORC conducts analysis of financial
statements as prepared by external firms
to ensure consistency with communicated
information.
MEORC represents over 20% of the 88
counties in the State which provides
access to and influence in the fiscal
analysis impact from rule changes. The
fiscal analysis involves various tiers
of information, countywide, MEORC-wide
and statewide.
Patient Liability Administration
MEORC manages the Medicaid
administrative functions related to
patient liability for applicable waiver
individuals. This function involves
database updates, analysis and
distribution of ODMRDD monthly patient
liability updates to county boards and
providers.
External Reviewers
MEORC serves as an external control
mechanism for member boards. MEORC
maintains the ability to remain one-step
removed from the member boards to ensure
that quality, impartial information is
available in the management of waiver
administration.
Policy and Procedure Development
Assist with the development of updated
policy and procedures related to member
board’s waiver administration in the
residential service arena. Advise member
boards regarding pending rules and their
predicted impact on local delivery
systems and on applicable policy and
procedures.
County Contact Meetings
Coordinates and facilitates routine,
update, and training meetings for
stakeholders to assist with the
successful administration of residential
waiver management. These meetings also
provide an avenue for networking with
other MEORC member boards. MEORC
arranges for CEU availability for staff
attendance to assist in maintaining
certification as ODMRDD approved growth
credits.
Liaison
With current participation of members,
MEORC represents over 20% of the 88
counties in the State, which
additionally provides a combined voice
to assist with change at the State
level. MEORC leadership staff serves as
representatives on State level
workgroups. MEORC communicates on behalf
of the members with providers, ODMRDD,
ODJFS and OACBMRDD.
Training and Technical
Assistance
MEORC coordinates and conducts training
for stakeholders in an effort to assist
members with the successful management
of residential waiver administration.
Some areas of training include, but are
not limited to, billing, provider
requirements, documentation, waivers,
fiscal impacts and rule changes.
Diagram #1 ISP Development County Board
Payment of Claim @ ODMRDD Utilization
Review
Packet Review Fiscal Analysis PAWS
DevelopmentPAWS Upload to ODMRDD
Start ** The entire circle is
repeated each time there is an ISP
revision with a fiscal impact
Quality Products
Accreditation Readiness
Core Product: Review Preparation
• Update on Accreditation Process
Changes and Standards
• Self Review Guidance
• Findings & Problem Solving
• Staff Training: Accreditation Process
& Specific Program Areas
• Document Organization and Preparation
• Document Review: Policy, Procedure,
Written Descriptions
• On-Site Review Support
• Plan of Correction Technical
Assistance
Value Added Benefits:
• Liaison (ODMRDD, ODJFS and OACBMRDD)
• Research
• Development / Revision of Policy and
Procedure
• Mock Review of Program Areas
• Staff / Board Training: Accreditation
Process
• Technical Assistance
• Law and Rule Notification
ACCREDITATION READINESS –
COMPREHENSIVE PRODUCT DESCRIPTION: CORE
PRODUCT/ REVIEW PREPARATION:
The MEORC Office of Quality provides
Accreditation Readiness which supports
customers in preparing for and
participating in Accreditation reviews
conducted by ODMRDD. The following
features are part of the core and may be
purchased separately a la carte. Value
added benefits are available to any
county purchasing the core.
Update on Accreditation Process
Changes and Standards
In preparation for the review, MEORC
informs the CB Superintendent and
administration of Accreditation’s
process and procedure changes since the
last review and will inform all staff,
as needed, of the same.
MEORC reviews the requirements of
applicable rule or other requirements
for a given standard with assigned
county board staff in the program areas.
The MEORC staff person will provide
information about new rule requirements,
training key staff on the requirements
and acceptable evidence for the
Accreditation review. County Boards will
be assisted with determining whether
their county processes allow them to
meet requirements and with developing
strategies for adjustment / correction
to their processes as needed.
Self - Review Guidance
MEORC evaluates the most recent
completed Self-Review for all standards.
MEORC will provide feedback to the
County Board regarding completion of the
Self-Review to ensure accurate and
meaningful responses.
Findings / Problem Solving
MEORC indentifies compliance issues and
informs the Superintendent and
department managers of areas of possible
citation. MEORC will work with county
board staff to develop adjustments and
corrections to systems and processes in
order to ensure future compliance.
Staff Training: Accreditation
Process / Specific Program Areas
MEORC prepares County Board employees
for the Accreditation Review.
Information will be provided on an
overview of the process, reviewer areas
of expertise, interview preparation,
time lines, and current standards. Key
County Board staff will be identified
and their efforts will be supported.
Document Organization and
Preparation
MEORC advises and assists the County
Board regarding ODMRDD requests to
develop the review sample. In addition,
MEORC assists with document collection
and preparation, reviewing key document
sections before submission as needed.
MEORC collaborates with key staff to
complete the interview and observation
schedule.
Document Review: Policy,
Procedure, Written Descriptions
MEORC reviews documents requested by
ODMRDD prior to submission to the
Department including; policies,
procedures and written descriptions.
Detected problem areas are conveyed to
the County Board staff.
On-Site Review Support
MEORC provides consultation and problem
solving services at the County Board
offices during the on-site review.
Plan of Correction Technical
Assistance
Provides guidance, as requested, to
develop the Plan of Correction in
response to citations received by the
County Board.
VALUE ADDED BENEFITS:
Liaison functions
MEORC communicates on behalf of the
members with: ODMRDD, ODJFS and
OACBMRDD. MEORC staff consults ODMRDD
and ODJFS on an on-going basis regarding
the review process, rule changes,
interpretation and clarification.
Research
MEORC conducts on-going research related
to requirements and “best practices” and
then reports this information to
Accreditation participants. In addition,
staff will research answers to questions
posed by county contacts or
participating county boards.
Development / Revision of Policy
and Procedure
MEORC assists with writing and editing
policies and procedures to meet rule
requirements. Proven example policies
and procedures will be provided when
available.
Mock Review of Program Areas
MEORC conducts reviews of selected
program areas using the Accreditation
Data Collection Instrument. MEORC
provides information regarding selected
individual cases and a systems analysis
of the program area with regard to
minimum compliance.
Staff / Board Training on
Accreditation Process MEORC
staff is available to provide training
to board members and designated staff
upon request.
Technical Assistance
Customers receive the benefits of MEORC
staff specialization and expertise as
requested.
Law and Rule Notification
MEORC staff informs appropriate
customers of rule and statute changes as
well as Department interpretations.
Medication Administration &
Health Related Activity Training and
Certification
Core Product:
• Medication
Administration & Health Related Activity
Initial Training and Renewal of
Certification Courses
• Insulin and G & J tube Initial and
Renewal Training
Value Added
Benefits:
• Registration and
Verification of Participant Requirements
• Monitoring of ODMRDD Medication
Administration Database Record
• Curriculum Materials and Supplies
Preparation
• Training Site, Nurse Trainer and
Participant Coordination
• Verification of Attendance and
Certification Attainment
• Certificate Mailing
MEDICATION
ADMINISTRATION & HRA TRAINING AND
CERTIFICATION - COMPREHENSIVE PRODUCT
DESCRIPTION:
CORE PRODUCT / INITIAL TRAINING AND
RENEWAL:
MEORC facilitates a cooperative effort
among participating county boards and
the MEORC Registered Nurse for the
ongoing training and maintenance of MRDD
personnel (provider and county board)
certification in the administration of
medications and the performance of
health related activities, per OAC
5123:2-6-03 and 5123:2-6-06.
Medication
Administration & Health Related Activity
Initial Training and Renewal
MEORC provides initial and renewal
training for medication administration
and the performance of health related
activities. This service is provided by
a MEORC Registered Nurse trainer and a
collaborative of participating county
board nurses who utilize the ODMRDD
mandated educational and testing
procedures.
VALUE ADDED
MEMBERSHIP BENEFITS:
Registration and Verification of
Participant Requirements
MEORC receives participant applications
that verify age, HS Diploma or GED,
Abuser Registry Check, Nurse Aide
Registry Check, and Criminal Background
Check and make approval for
participation.
ODMRDD Medication
Administration Database Record
MEORC registers attendees
in the ODMRDD Medication Administration
Database prior to the class to ensure
that applicants for the 14 hour course
are not already certified and that no
registrant’s certification has been
suspended or revoked.
Curriculum
Materials and Supplies Preparation
MEORC prepares curriculum packets for
all participants and maintains supplies.
This includes production of an
instructor’s training booklet, tests and
answer sheets.
Training Close to
Home Determines need for
training based on location and needed
certifications. Trainings are scheduled
at times and locations as determined by
assessed need.
Verification of
Attendance and Certification Attainment
MEORC receives and verifies participant
testing results and ensures
collaboratively with participating
nurses or MEORC nurse that attendees who
pass the class are issued certificates.
Certificate
Mailing
All certificates are mailed to attendees
and if applicable, to their employers,
either by MEORC or by the participating
nurse trainer.
Record Keeping
MEORC maintains participant records
related to course application,
participant outcomes and certification
requirements.
Bi-Annual Nurse
Collaborative Contact Meetings
Facilitates a bi-annual nurse
collaborative meeting for county board
nurses to provide updated information
related to rule changes, best practice,
training, and health management issues.
Improvement to the process will be based
on identified customer needs.
Participating nurses provide feed back
on services and sign up to participate
in the Training and Certification
classes as needed.
Quality Outcomes
and Statistical Analysis
MEORC provides routine updated
information and statistical analysis
related to training services to assist
county board nurses with focus areas of
medical need and information related to
MRDD personnel who are currently
certified.
Nurse Quality Assessment Review
Core Product: Nurse Quality
Assessment Review
• Standardized Review
Process
• Registered Nurse Consultation and
Oversight
• Written Reports
Value Added
Benefits:
• Liaison
• Staff Specialization and Expertise
• Bi-Annual Nurse Contact Meetings
• Quality Outcomes and Statistical
Analysis
NURSE QUALITY
ASSESSMENT REVIEW – COMPREHENSIVE
PRODUCT DESCRIPTION CORE PRODUCT/
NURSING QUALITY ASSESSMENT REVIEWS:
MEORC provides a registered nurse to
provide quality assessment reviews at
least every 3 years for each individual
receiving administration of prescribed
medications or performance of
health-related activities by MR/DD
personnel in a format prescribed by the
department in accordance with OAC
5123:2-6-07.
Standardized
Review Process
The MEORC Registered Nurse
provides external quality assessment
reviews through a protocol established
by the Department. These reviews will be
conducted for individuals receiving
services from certified HCBS waiver and
supported living providers in settings
of community living arrangements that
include not more than four individuals,
or individuals residing in residential
facilities of five or fewer beds.
Registered Nurse
Consultation and Oversight
The MEORC Registered Nurse provides
expertise which is available to the
county board nurses as circumstances
arise with individuals who receive
services from certified HCBS waiver and
supported living providers.
Written Reports
Written reports are provided to the
county board and the provider, including
any recommended steps to improve the
functioning of the trained MR/DD
personnel and to
maintain compliance. The Registered
Nurse will maintain a copy of each
quality assessment review.
VALUE ADDED
BENEFITS:
Liaison
The Registered Nurse acts as a liaison
with the Department, representing the
MEORC customers utilizing this product.
Staff
Specialization and Expertise
The Registered Nurse specializes in the
area of MR/DD personnel certification in
administration of medications and
performance of health related
activities.
Bi-annual Nurse
Collaborative Meetings
MEORC facilitates a bi-annual nurse
collaborative meeting for county board
nurses to provide updated information
related to rule changes, best practice,
and health management issues.
Improvement to the process will be based
on identified customer needs.
Quality Outcomes
and Statistical Analysis
MEORC collects and analyzes data
regarding assessment results. This
information will be utilized to educate
the county boards and providers; and to
determine future needs for product
development.
Provider Compliance Review
Core Product:
Provider Compliance Review
• Complete Provider
Compliance Reviews in Accordance with
5123:2-9-08
• Review each Provider within a Five
Year Cycle
• Preliminary Report
• Plan of Compliance Assessment
• Final Report Submitted.
Value Added
Benefits:
• Liaison
• Staff Specialization and Expertise
• Quality Outcomes and Statistical
Analysis
PROVIDER
COMPLIANCE REVIEW - COMPREHENSIVE
PRODUCT DESCRIPTION:
CORE PRODUCT/ PROVIDER COMPLIANCE
REVIEW:
MEORC conducts provider
compliance reviews of certified
providers for the purpose of determining
provider compliance with applicable
requirements in order to ensure the
health, safety, and welfare of the
individual in accordance with
5123:2-9-08 (OAC). Each provider will be
reviewed at least every five years or at
least once during the term of their
certification as assigned by the
department annually. Special provider
compliance reviews are conducted on
behalf of county boards when there is a
concern that results from a complaint
and/or unusual or major unusual
incidents.
VALUE ADDED
BENEFITS:
Staff Specialization and
Expertise
MEORC staff trained in ODMRDD protocol
specializes in provider compliance
reviews developing an expertise in this
designated product.
Liaison
The Quality Department serves as a
liaison with the ODMRDD Office of
Provider Standards and Review to
facilitate the incorporation of new
rules and protocols into the review
process, as well as communicate the
areas that need to be addressed in the
review process.
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Quality Assurance Review
Core Product: Quality Assurance
Review
• Complete Quality Assurance Reviews for
Individuals Receiving Supported Living
Services within a Three Year Cycle
Value Added Benefits:
• Standardized Interview Process
• Review of ISP vs. Documentation
QUALITY ASSURANCE REVIEW –
COMPREHENSIVE PRODUCT DESCRIPTION: CORE
PRODUCT / QUALITY ASSURANCE REVIEWS:
MEORC conducts quality assurance reviews
in accordance with 5123:2-12-01 (OAC) to
ensure that individuals receiving waiver
and other supported living services are
empowered to exercise choice and enhance
the quality of their lives. These
reviews will consider the quality
indicators of choices and options,
personal income, housing, community
membership, personal satisfaction,
health, and safety. They will be
completed for each individual within a 3
year cycle.
A final written summary report is
provided to the individual, the
guardian, the superintendent of the
county board or designee, the provider,
and the person responsible for
coordinating the ISP development for the
individuals.
VALUE ADDED BENEFITS:
Standardized Interview Process
Quality Assurance Specialists conduct
standardized interviews with the
individual, family members, guardian,
providers, and other interested parties
as identified by the individual. The
purpose of these interviews is to
determine the individual’s involvement
in the ISP development process, level of
satisfaction, and receipt of services
identified on the ISP. Interviews are
completed by MEORC staff assuring an
external review process.
Review of ISP vs. Documentation
A review comparing the ISP to the
provider documentation is conducted to
assure that the choices expressed by the
individual and written in the ISP have
been implemented.
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QSS Quality Service System
Core Product:
• Use an Aligned Systems Approach to
Improving Performance
• Core Values Guide Decision Making and
Drive Improvement
• Use the Learning Cycle and Employ Key
Strategies for Improving Performance
• Establish and Measure System Outcomes
• Results; Creating Value for
Individuals and Families
Value Added Benefits:
• Products Designed to Increase
Availability of Quantitative Data
o Integrated Service Plan (In Development)
o Quality Assurance Review for all Enrollees of
the County Board
o Quality Assurance Review as Required for SL
Service Recipients
o Provider Compliance Review
o Web-Based Community Survey Tool
• Accreditation / Targeted Process
Improvement
• Liaison (ODMRDD, ODJFS and OACBMRDD)
• QSS Staff Research and Share Concepts
Regarding Quality
• Members Collaborative
QUALITY SERVICE SYSTEM –
COMPREHENSIVE PRODUCT DESCRIPTION:
MEORC and county board participants in
the Quality Service System Demonstration
Project are working to become high
performing agencies through the use of
The Performance Excellence Model. The
project is designed to assist county
boards with, Strategic Leadership,
Execution Excellence and Organizational
Learning.
CORE PRODUCT/QUALITY SERVICE
SYSTEM:
The System: Using an
aligned systems approach
QSS participants enhance their
organization’s ability to improve
performance in the areas most important
to their success; ensuring that
individuals and families are better off.
A Proven
Aligned Systems Approach
is used…To Achieve Results.
The following categories are aligned to
work together to accomplish the
organizations goals.
– Leadership
– Strategic Planning
– Customer Focus
– Process Management
– Workforce Focus
– Measurement, Analysis, and Knowledge
Management
The Values: QSS
participants embrace core values that
are used to guide decision making and
drive improvement.
The Outcomes: QSS
participants collaborate
for the purposes of benchmarking
performance and getting
better. Common desired system
outcomes are agreed upon by the
membership and measured. Strategies
attributed to high performance, are
shared among participants.
The Strategies: QSS
participants use the learning cycle
throughout the system categories and to
improve key processes to become High
Performing Organizations.
Key Strategies for Improving
Performance
– Software / Technology Exploration and
Advancement
– Quality Systems Training
• The Foundation - Core Concepts and Values
• Foundations in Strategic Planning
• Use of Quality Tools
• The Learning Cycle
– Measurement, Analysis, and Knowledge
Management Training
• Increasing Data Consumer Skills
• Developing System Outcomes and Indicators
• Using Data for Process Improvement
– On-Going Facilitation, Consultation,
Tool Development
• Receive Customer-Directed Support for data
analysis, strategic planning, and key
process improvement
• On-Going Tool Refinement - Capturing
Information and Analysis
• Organizational Learning
The Results:
QSS Participants focus on results and
create value for individuals and
families (their customers) and
stakeholders. Agencies purchasing QSS
become aligned and engage in an exciting
process of continuous improvement.
VALUE ADDED BENEFITS
The Products:
QSS Participants have access to diverse,
complementary products and services that
provide access to quantitative data
about what their customers want and need
and about their organization’s
performance. – Integrated Assessment,
Planning, Documentation and Review (In
Development)
– Web-Based Community Survey Tool
– Individual and Family Survey / QAR
– Provider Compliance Reviews
Accreditation Preparation:
MEORC provides Accreditation Readiness
services focused on targeted process
improvement.
Liaison:
MEORC communicates on behalf of the
members on an on-going basis with ODMRDD
and ODJFS.
Research on Quality:
MEORC conducts on-going research related
to quality systems and quality tools.
On-Going Facilitation:
The MEORC Quality Team supports process
improvement teams at the county board
level. Use of quality tools,
measurement, analysis, and knowledge
management is facilitated.
Members Collaborative:
QSS members collaborate for the purpose
of developing sources of comparative
data, sharing innovative practices and
developing products that allow for
flexibility and innovation at the county
board level.
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Investigative Service Products
Core Product: MUI Investigations
• Complete Investigation of MUIs in
Accordance with 5123:2-17-02
Value Added Benefits:
• Liaison
• Policy and Procedure Development
• County Contact Meetings
• Training and Technical Assistance
• Quality Outcomes and Statistical
Analysis
• Participation in Review Processes
INVESTIGATIVE SERVICES –
COMPREHENSIVE PRODUCT DESCRIPTION: CORE
PRODUCT / MUI INVESTIGATIONS:
The Office of Investigations for MEORC
implements a Major Unusual Incident
Investigation Program utilizing
consistent processes thru the use of
Investigative Agents, certified in
accordance with 5123:2-17-02 (OAC),
which support stakeholders in responding
to, assisting with and averting threats
to the health, safety and welfare of the
individuals served.
Investigation Program
MEORC-MUI operates a flexible and
responsive unit of investigators, twenty
four hours a day seven days a week, with
availability and emergency contact
available via cell phone. Implements
internal control and oversight
procedures to ensure that quality
information in regarding the
investigation is completed and provided
in a format to ensure that subjectivity
is not a part of the report.
As the Investigative Agent, MEORC
participates in any external process
related to the Abuser Registry, Criminal
Court Cases, Provider Certification
Processes and Unemployment
claims/denials as related to the Major
Unusual Incident process.
MEORC-MUI assumes all responsibility
associated with personnel issues related
to the Investigative Agent’s, thus
eliminating and/or sharing the
responsibility with the stakeholders.
VALUE ADDED BENEFITS:
Liaison
Successful and positive relationship
with ODMR/DD and, in many instances,
serves as liaison for stakeholders.
Advises member county boards on pending
rules and their predicted impact on the
local delivery system.
Works with and provides information to
the ODMR/DD’s Abuser Registry staff for
the review and placement of offenders on
the Abuse Registry.
Develops, maintains and improves
relationships and training with Children
Services Bureau and Law Enforcement as
well as other community agencies.
Serves on state committees as requested
in order to provide a collective voice
(representing 20% of the State of Ohio’s
88 County Boards) to ensure that the
needs/concerns of the participating
County Boards are heard.
County Contact Meetings
Coordinates/conducts routine training
meetings for stakeholders to assist with
the successful administration of
services. Assists participants to
connect with neighboring County Boards
to share information regarding
successful procedures. These training
meetings provide CEU’s to assist staff
in maintaining certification as ODMR/DD
approved growth credit.
Policy and Procedure Development
Assists with the development of updated
policy and procedures related to the
Major Unusual Incident Rule and mandates
associated with the process.
Advises member county boards on pending
rules and their predicted impact on the
local delivery system.
Provides the stakeholders with
assistance and wording relative to local
Policy and Procedures associated with
the Major Unusual Incident Rule and its
related components.
Training and Technical
Assistance
Stakeholders receive the benefits of
Investigative Agents from MEORC staff
and the specialization and expertise in
the area of health and safety.
Available on a daily basis for technical
assistance to review specific details of
incidents to ensure appropriate
classifications and determination as a
Major Unusual Incident.
Serves as a resource to stakeholders for
written forms and verbal assistance when
developing processes or handling unique
situations.
Provides individualized training and
technical assistance to staff that is
completing the Administrative duties
required by rule to ensure that
compliance standards are implemented and
monitored.
MEORC-MUI provides individual technical
assistance to ensure that stakeholders
are provided with the needed tools to
ensure appropriate reporting and
investigating in accordance with the
Major Unusual Incident Rule.
Assists with coordinating and conducting
Major Unusual Incident Rule training
regionally/locally to assist
stakeholders in meeting the requirements
of annual and ongoing Rule Training.
Provides technical assistance in regards
to what customized processes appear to
work best for other counties and how a
process can be implemented to assist
each individual stakeholder.
Provides stakeholders with updated
information regarding changes which
occur in the system and assists in
making changes in processes in
accordance with mandates.
Provides assistance to stakeholders
regarding the prevention of similar
Incidents occurring in the future based
upon past experience related to unique
situations.
Quality Outcomes and Statistical
Analysis
Provides routine updated information and
statistical analysis related to the
Major Unusual Incident process to assist
stakeholders with the monitoring and
measuring of outcome based services and
the improvement of the delivery of
services.
Due to the unique structure and
availability of statistical data,
MEORC-MUI is able to provide an analysis
of trends/patterns and county to county
comparisons in terms of the total of
Major Unusual Incidents and also types
of the types of Incidents reported.
Participation in Review
Processes
Provides historical information in
regards to the outcomes of recent
reviews which assists in making
immediate changes to internal processes
and improve the delivery of services for
the future. Prepares stakeholders for
the external review processes conducted
by outside entities through the
implementation of a “reciprocal
oversight process”. This process
identifies areas which require
improvement both in the investigation
and Administrative processes required by
rule.
Attends, participates and assists the
stakeholders and ODMR/DD in all annual
reviews, accreditation reviews and
registry reviews conducted at the county
level with hands on experience of a
minimum of 18 reviews annually.
Assists stakeholders with Plans of
Corrections necessary to maintain
compliance with the Major Unusual
Incident rule and assists with the
implementation of new processes to
overcome these barriers. Assists
stakeholders with input related to the
completion of Accreditation, Quality
Outcomes Processes, Plans of Corrections
and Best Practices Standards, as well as
all other external review processes.
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MEORC Pricing
(effective 3-1-08)
Nurse Quality Assessment Reviews
|
Nurse Quality
Assessment Reviews
|
$240 per
occurrence
|
Medication Administration and
Health Related Training and
Certification
|
Initial
Certification 1
|
$80 per
participant
|
|
Initial
Certification 2 and 3
|
$60 per
participant
|
|
Continuing
Education Certification 1, 2, or
3
|
$40 per
participant
|
|
Authorized Representative Payee
|
$35 per month
per individual
|
Special Note: The majority of
MEORC products are typically purchased
through bundling of products/services to
address common customer needs. The
bundling of products and services
results in less cost and increased value
for our customer.
Please contact MEORC and request
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