CareStar wants you to have all the answers you need at your fingertips. That's why we have a variety of resources for you to find information.

1. Who is CareStar?

2. Is there a fee for Case Management?

3. What is a Case Manager?

4. When should I call my Case Manager?

5. How do I reach my Case Manager?

6. How often will I receive a visit from my Case Manager?

7. What specific things can my Case Manager help me do?

8. What is a Home Care Team?

9. What are Core Home Care Services?

10. What is the individual cost range?

11. What are daily living services?

12. What is an All Services Plan?

13. If I don’t use all the services or hours calculated in my monthly cost, can I save them for use in a future month?

14. What should I do if my nurse or aide doesn’t arrive when I’m expecting him/her?

15. Why do I need a back-up caregiver or plan?

16. What should I do if I have a complaint about any of my services or providers?

17. Do I have any choice in the selection of agencies or individual caregivers?

18. What do I do if a service is denied, or a decision is made and I don’t agree?

19. What if I’m not pleased with my Case Manager?

20. Who should I call if I have an emergency?

21. Will I have any privacy?

22. Now that I have Case Management services, do I have to continue my involvement with the County Department of Job and Family Services?

23. Will anyone other than my Case Manager check with me to see if I am happy with the program?

24. I can manage my own care. Do I have to have all this involvement?

25. I have CORE Plus Benefits and have a “spend- down”. How do I handle this?

26. I have the Waiver with a “patient liability”. What does this mean?

1. Who is CareStar?
CareStar is a privately owned company that has contracted with the Ohio Department of Job and Family Services to provide Case Management. CareStar will furnish your Case Manager and a Home Modification Specialist. CareStar maintains a list of service providers and community resources to help you in your home care choices.

2. Is there a fee for Case Management?
There is no charge to the consumer for the services of CareStar. The Ohio Department of Job and Family Services has provided this for you to ensure that you have access to needed services.

3. What is a Case Manager?
A Case Manager is a registered nurse or a licensed social worker. He/she has completed special training to be able to coordinate the services that you may need. He/She will serve as the leader for your Home Care Team.


4. When should I call my Case Manager?
You should contact your Case Manager any time you have concerns about your ability to remain safely in your home. This may include, but is not limited to, when
* your services are not meeting your needs
* your home situation changes
* your health changes
* you make a trip to the emergency room, or are treated for an infection
* you are unhappy with a provider or a service
* you want to change a provider or service
* you have questions about community resources
* You experience a hospital or nursing home admission

5. How do I reach my Case Manager?
You may contact your Case Manager by calling the CareStar office number found on page 3. The work hours for CareStar are 8:30 am until 5:00 pm Monday through Friday. Our phone is answered seven days a week at all hours. If your Case Manager is not in the office, you may leave a message on his/her voice mail or speak with a supervisor. Your Case Manager will give you his/her direct voice mail number written on pages 3 and 12. This gives you an opportunity to leave a message for him/ her without speaking to office personnel. Case Managers respond to all voice messages by the end of the next business day. Urgent issues should be brought to the immediate attention of a Supervisor.


6. How often will I receive a visit from my Case Manager?
Your Case Manager will contact and visit you more frequently when you are first approved for Core Plus or Waiver, then the frequency of visits may be reduced. If a problem occurs, like a trip to the hospital, your case manager will make an extra visit. Your Case Manager will establish a schedule with you but never hesitate to call your case manager anytime you have any questions or concerns.

7. What specific things can my Case Manager help me do?
Depending on your program, your case manager can help you:
* find a nurse or daily living services provider or change to a different provider.
* arrange for meals to be delivered
* have an emergency response system installed if medically indicated.
* coordinate short-term relief if an urgent need for the primary caregiver to be out of the home.
* talk with school officials or community agencies to help resolve any troubling issues
* inform you of your choices if your services or living arrangements are not meeting your needs.
* assist in obtaining equipment, home modification and adaptive/assistive equipment.


8. What is a Home Care Team?
A home care team is the joining of all individuals and agencies that assist you to obtain your home care goals. In addition to you, your team may include family members or friends, nurses or aides from agencies, therapists, volunteers from church, and your Case Manager. Most importantly, your team is comprised of those who you have identified as contributors to your ability to remain safely at home.

9. What are Core Home Care Services?
CORE Services are nursing services, daily living services, and skilled therapy services available to Medicaid consumers in the Core Benefit Package, the Core Plus Benefit Package and the Waiver Benefit Package.

10. What is the individual cost range?
The Home Care Team establishes goals and identifies services based on the consumer’s functional abilities, living conditions, and medical necessity. The cost range is the monthly amount of money approved to be spent on your Medicaid home care needs.


11. What are daily living services?
Daily living services are services paid for by Medicaid, which assist consumers in carrying out the normal activities of daily life. Activities that would typically be self performed if functional ability was present. They may include bathing, dressing, grooming, hair care, oral hygiene, skin care, feeding, toileting, assisting with ambulation, positioning, and transfers. General household activities that are essential to the consumer’s health and safety, such as, preparation and cleanup of meals, laundry, bed making, dusting, vacuuming, errands and other routine chores may also be included. In the past, these services were referred to as home health aide services.

12. What is an All Services Plan?
This is a document that your Case Manager develops with the input of the home care team. It specifies all the services necessary for you to remain in your home. The All Services Plan lists your goals, the needed services, the service providers, the cost of services and who is liable for payment, your decision regarding consumer options, and your home care team members. The All Services Plan provides prior authorization for Medicaid services providers. It is important that the consumer and providers receive a copy of the All Services Plan and understand its contents.


13. If I don’t use all the services or hours calculated in my monthly cost, can I save them for use in a future month?
No! The services must be provided as stated on the All Services Plan because they were determined to be medically necessary. There is no “banking” of hours; however, if in a future month a need develops, the Service Plan can be adjusted.

14. What should I do if my nurse or aide doesn’t arrive when I’m expecting him/her?
If your service is provided by an agency, call the agency. Do not delay. They may have back-up help available or assist you with other arrangements. If expected services are not delivered, call the provider and/or go to your back-up plan.

15. Why do I need a back-up caregiver or plan?
Unforeseen circumstances, such as, sickness and inclement weather may prevent your nurse or aide from providing services. Be prepared with alternatives rather than jeopardize your safety.


16. What should I do if I have a complaint about any of my services or providers?
If you have a complaint, let the individual or agency know why you are not pleased. If the situation is not resolved, contact your Case Manager.

17. Do I have any choice in the selection of agencies or individual caregivers?
Yes! As director of your Home Care Team, it is very important that you have an opportunity to choose your team members. Your Case Manager can supply a listing of providers and will help you identify some important issues to consider when making such choices.

18. What do I do if a service is denied, or a decision is made and I don’t agree?
The Ohio Department of Job and Family Services offers you an appeal process. You will receive a notice of the denial and be given an opportunity to appeal the decision at a hearing. Your Case Manager or Clinical Supervisor will assist you during this process. A hearing may be requested at any time; however, if it is completed within fifteen (15) days, services may continue pending the results of the hearing.


19. What if I’m not pleased with my Case Manager?
If you are not pleased with your Case Manager, please talk about your feelings with him/her. If you do not get the results you expect or if you are not comfortable talking with him/her, call CareStar’s office and speak to the Supervisor. To read the complaint/grievance procedure click this link.

20. Who should I call if I have an emergency?
If you have a medical emergency, call your doctor or 911. Situations that cause you some concern should be referred to your service provider and your Case Manager. It is best to bring these concerns to your Case Manager before they become an emergency.

21. Will I have any privacy?
Receiving health related services in the community does involve allowing agencies and individuals access to your private home. This access should not exceed what is minimally necessary. Your records are protected by Case Management policy and federal standards (HIPAA) from any unauthorized or unnecessary disclosure.


22. Now that I have Case Management services, do I have to continue my involvement with the County Department of Job and Family Services?
Yes! In order to receive Case Management services, you must be eligible for Ohio Medicaid. This is determined by the County Department of Job and Family Services. It is very important that you respond to any communication from the county and keep all appointments as scheduled.


23. Will anyone other than my Case Manager check with me to see if I am happy with the program?
CareStar will complete consumer satisfaction surveys with a random sampling of consumers. Staff from the Ohio Department of Job and Family Services will be making visits to selected consumers. You may be contacted and asked to offer an opinion. We welcome your involvement and value your opinion.

24. I can manage my own care. Do I have to have all this involvement?
The Ohio Department of Job and Family Services and CareStar must follow the rules that govern the Ohio Home Care Program. The frequency of contacts and home visits is included in these rules. You will be given opportunity and support to express your preferences and make decisions regarding your care and life within the community.


25. I have CORE Plus Benefits and have a “spend-down”. How do I handle this?
The County Department of Job and Family Services determines financial eligibility. If you have a spend-down, that amount of expense must be incurred before your Medicaid is effective each month. Your card is not released until the County Department receives proof that the amount of your spend-down has been incurred. You may pay the amount of the spend-down directly to your County Department of Job and Family Services on the first day of the month, then the card can be immediately released or you may make arrangements with your pharmacist, your home care agency, or your medical supplies provider.


26. I have the Waiver with a “patient liability”. What does this mean?
When the county Department of Job and Family Services determines financial eligibility and it is found that the monthly income exceeds the allowable amount, a patient liability is assessed. This is the amount of money that you will need to spend out of your pocket towards your needed Waiver services. Your facilitator will assist you in identifying which service and provider will receive your liability payment. You will receive your Medicaid card on the first of the month automatically.