Ohio House Rolls Back Additional DODD Funding for Community Services
By Rose Frech
Guest Author
May 10, 2017

The Ohio House recently approved its version of the two-year state budget (H.B. 49), taking aim at key provisions in the budget introduced by Governor Kasich. This newest version of the spending bill includes significant alterations in proposed funding for the Ohio Department of Developmental Disabilities (DODD), and axed many, though not all, of the new investments introduced by the administration.

The executive budget, released in February, was ambitious in its funding of the Department, through a proposed commitment of $122 million in additional state and federal dollars. In large part, these funds were intended to support the administration’s efforts to decrease the state’s over reliance on institutional care for individuals with developmental disabilities. The developmental disabilities system has struggled to keep up with waiting lists for home and community-based service (HCBS) services, which allow individuals with disabilities to receive the services necessary to stay in their homes, and avoid institutionalization. Cash-strapped counties are often unable to meet the demand with local funds. The waiting list exceeds 40,000 individuals, including some individuals currently residing in institutions who want to leave. Efforts to date aimed at “rebalancing,” or better supporting community-based services in lieu of institutions, have been met with a mixture of praise and cynicism, as some view the administration’s efforts as inadequate to address the need.

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Governor’s DODD Budget Includes Investments in Waiver Spending and Rate Increases
By Rose Frech 
Guest Author
March 6, 2017

Governor Kasich’s recently released executive budget includes several noteworthy adjustments to funding within the state’s developmental disabilities system. Touted as an extension of the state’s “historic” investments of the previous budget cycle, the proposal includes increased funding on several important initiatives.[i] However, the budget includes some notable cuts as well. Overall, the budget proposes a small increase in overall spending; a 5 percent increase for FY 2018 and an additional 4 percent increase into FY 2019.[ii] The combination of cuts and investments is likely to draw a mixture of support and criticism. While some will likely laud the governor’s commitment to sustained funding in an otherwise tight budget cycle, others may find fault in what they perceive as an ongoing underinvestment in needed community-based services and supports.

The budget proposal includes $122 million in new spending, which includes both state and federal contributions, primarily focused on efforts to expand community living options for individuals with developmental disabilities. This comes in the form of funding for approximately 1,300 new home-and-community based service (HCBS) waivers, which allow individuals to waive their right to institutional care in favor of receiving services in a home or community-based setting. These waivers are aimed at both continuing to assist individuals living in institutions who may want to leave, and addressing the state’s lengthy waiting list to access waiver services. State funding for waivers created during the past budget cycle will remain, however due to excessive demand, thousands will continue to wait.

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DODD Scorecard Suggests Progress on Budget Initiatives has been Slow
Rose Frech, Research Fellow
May 5, 2016

The Ohio Department of Development Disabilities (DODD) recently released updated data highlighting progress on several key initiatives, including expanding home-and-community based service (HCBS) waiver enrollment and increasing access to community employment. These initiatives were developed as a result of the last biennial budget, which included a $300 million investment in DODD services, mostly aimed at increasing access to community living for individuals with developmental disabilities.  Overall, the new data scorecard suggests that progress has been slow over the first three quarters of the year, and much headway will be necessary to achieve the goals outlined during the budget process.

HCBS Waivers

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CMS “unlikely” to Grant Ohio 10 Years to Integrate Waiver Service Settings
By Rose Frech, Fellow
March 1, 2016

According to a recent update released by the Ohio Department of Developmental Disabilities (DODD), the Department now finds it “unlikely” that the Centers for Medicare and Medicaid Services (CMS) will grant Ohio ten years to transition to delivering all of their home-and-community-based waiver services (HCBS) in integrated settings. Read the full statement here. This announcement comes as a result of new waiver regulations released by CMS in 2014, intended to guarantee that individuals served through Medicaid Waiver programs have access to integrated, community services to the same degree as individuals not receiving waiver services, and is a part of a broader shift away from segregated services for individuals with disabilities. The new rules emphasize that HCBS must “...ensure that individuals receiving services and supports through Medicaid’s HCBS programs have full access to the benefits of community living, and are able to receive services in the most integrated setting.” (What is an HCBS Waiver? Watch our animated video to find out.)

This will have a considerable impact on sheltered work and adult day services, as they have traditionally been delivered in Ohio, because these services will likely no longer meet the revised waiver requirements. Residential services funded through waivers will also be effected, as the new rules clearly state that HCBS cannot be reimbursed for institutional settings (like hospitals or nursing homes) or settings that are determined to be “institution-like,” by sharing qualities of institutional settings, such as segregation and regimentation.

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