Ohio Department of Developmental Disabilities

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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The Social Services Block Grant is under attack. What does this mean for Ohio?
By Rose Frech, Research Fellow
March 18, 2016

The House Ways and Means Committee announced last week that Chairman Kevin Brady (R-Texas) is sponsoring legislation that would end the Social Services Block Grant (SSBG), a $1.7 billion dollar grant allocated to states to fund numerous critical social service programs. And on Wednesday, this bill was one of several that passed through the Committee, in an effort to create budget savings. The other two pieces of legislation that the Committee passed include changing the refundable child tax credit to require a Social Security number, and a bill that would require those who receive overpayments of ACA exchange subsidies to repay them.

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MBR Bill Proposes More Change for Developmental Disabilities System
Rose Frech, Fellow, Applied Research
March 9, 2016

Services for individuals with developmental disabilities in Ohio may see more changes through the recent proposals outlined in House Bill 483, introduced last week. Sponsored by Representative Amstutz, the House Bill is a part of the mid-biennium review (MBR), a Kasich construct, which allows the administration to advance policy initiatives in off-budget years through working with members of the General Assembly to offer a series of pieces of legislation. The legislature will have the opportunity to evaluate and vote on these proposals in April, when the MBR bills come up on the docket. These proposed changes come on the heels of a significant investment in services for individuals with developmental disabilities provided by the 2016-2017 budget (you can read more about those investments here).

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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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