Each step of the enrollment process can be complex and lengthy. The biggest factor in the length of time is obtaining the needed evaluations for OPWDD eligibility. Everyone applying for CCO services is assigned to a dedicated Care Connection Specialist to navigate the process. Care Connection Specialists can also provide linkage to Family Support Services and other systems of care if needed.
Please remember that once a person begins enrollment, the CCO must communicate directly with them, their legal guardian, or their representative. CCO enrollment staff can only discuss a specific person’s enrollment with provider agencies if the person makes the request directly and signs a consent to authorize information sharing.
The length of time it takes for a person to enroll in a CCO depends on factors including, but not limited to:
- Age, particularly children under eight years
- OPWDD eligibility
- Medicaid status
The following is a general list of the steps to enrolling in a CCO. The order will vary depending on each person’s circumstances.
Contact the Front Door at OPWDD
All people seeking CCO enrollment must start by contacting the Front Door at the OPWDD Regional Field Office for their area to express their interest in services. They will participate in a phone assessment with Front Door staff, which takes place after eligibility, and must complete the required training about all services funded under OPWDD. The Front Door staff will also provide people with a list of CCOs that provide services in their area so they can choose which CCO they would like to pursue services from.
Determine OPWDD Eligibility
Every person enrolling in a CCO is required to have OPWDD eligibility. To be eligible, OPWDD must determine the person has a qualifying disability. The disability must be diagnosed by a medical professional, be present before the person’s 22nd birthday, cause a substantial handicap to their adaptive abilities, and be expected to be permanent. Detailed information on the OPWDD eligibility requirements and process is available on their website.
Apply for Medicaid
At the time of CCO enrollment, the person must have active Medicaid through their local district and must be active and compatible. Our eligibility department supports with Medicaid applications.
If the person is under age 18 and not eligible for Medicaid based on family income, they must first apply for an HCBS Waiver with a qualifying service. OPWDD does not consider Respite or Self-Direction to be qualifying services for HCBS Waiver.
At ACANY, the Care Connection Specialist will assist the person with applying for Medicaid and HCBS Waiver, if applicable. If the HCBS Waiver application is denied by OPWDD, the child cannot enroll in a CCO at that time. If that occurs, the Care Connection Specialist can refer the child to Family Support Services or other systems of care that may be more appropriate.
Level of Care Eligibility Determination (LCED)
CCO enrollment staff will assist with obtaining an initial LCED from OPWDD. To obtain an LCED, the person must have a psychosocial and medical evaluation dated within the past 365 days and a current psychological evaluation. It is preferable to do a psychological evaluation within three years. If older, it is up to the DDRO’s discretion. The DDRO may request adaptive scores within the last year. For Regions 3 and 5, an MD, NP, or DO signature is required on the LCED.
Submit Request for Enrollment
Once a person has obtained OPWDD eligibility, Medicaid, LCED, and required signed consents, the CCO’s enrollment staff will submit a request for enrollment via CHOICES. All CCO enrollments occur on the first of each month. Once OPWDD approves the request, the CCO will assign a Care Manager.