MBR Bill Proposes More Change for System

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).

The most notable of the changes proposed in HB 483 will impact services for infants and toddlers with developmental delays. These children are served through Ohio’s Early Intervention (EI) system, which is currently housed within the Ohio Department of Health (ODH). The system, also referred to as “Ohio Help Me Grow Part C,” is tasked with identifying and providing services to children under the age of three with delays or disabilities. While the Ohio Department of Developmental Disabilities (DODD) has been closely involved in the delivery of these services, ODH has remained the lead agency. HB 483 would shift responsibility for the program to DODD, who would take on the role of lead agency. This decision was made to ensure continuity of care for children who may need ongoing supports and services from County Boards of Developmental Disabilities beyond age three. And, according to DODD, “naming DODD as lead agency recognizes the tremendous financial support of County Boards and will leverage their local expertise, knowledge, and background.” This change does not change the amount of money spent on the program, but rather shifts $11 million in state funding from ODH to DODD. Advocates, including the Ohio Association of County Boards of Developmental Disabilities (OACBDD) and Disability Rights Ohio, have vocalized support for these changes. Details are not yet available on the specifics of how this change will impact children currently enrolled in the program. In 2014, there were nearly 25,000 referrals for EI services and over 10,000 children receiving EI services at any given time. ODH will continue to operate the state’s home visiting program, designed to support healthy pregnancies, provide parent education, and promote the health and development of young children.

Another change proposed in the bill would expand the health activities that home care providers are permitted to administer when serving individuals with disabilities. Currently, existing regulations limit direct care staff in home care settings from administering certain medications or performing certain health activities. This can place a burden on the individuals who require these interventions, and in some cases, the individual’s family members, who often need to coordinate to administer these medications or health activities themselves despite a home-provider being present. HB 483 would expand the list of medications that are permissible for direct care staff to administer to include inhalers, insulin, over-the-counter topical treatments, and others, and would allow for these providers to complete an expanded list of basic health activities.

In addition to these proposed policy amendments, there are several other smaller changes outlined in the bill, which are described by DODD in a statement on the MBR (available here). You can find the bill in its entirety here.