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Jul 14
DODD Outlines FY18-19 Budget Initiatives

June 30, 2017, Gov. John Kasich signed the Fiscal Year 2018-19 biennial operating budget (HB49) for the State of Ohio, bringing the budget process to a close.

The current operating budget builds on the historic $286 million investment made two years ago by investing $65 million in new dollars over the biennium.

This new funding makes possible the initiatives outlined below and will strengthen opportunities for people with developmental disabilities to receive services in the community as well as meet the needs of those living at intermediate care facilities (ICF).

Home and Community-Based Services Waivers

The budget continues to prioritize home and community-based services and makes the following investments in programs that support individuals who choose to live and work in the community.

  • Increases options for individuals who prefer a waiver setting. The operating budget continues funding to support the 3,000 waivers created in the last budget and adds approximately 750 new waivers to reduce waiting lists and provide opportunities for individuals who prefer a waiver over living in an ICF.

  • Increases waiver reimbursement to cover complex care needs. Individuals who are dependent in all areas of daily living require a workforce that is stable and well trained to meet their everyday needs and maximize their quality of life. The operating budget incentivizes providers to serve complex individuals by creating a complex care rate add-on starting in the fall of 2017.

  • Increases wages for direct support staff. DODD depends on direct service staff to provide support to more than 90,000 individuals in the developmental disabilities system. Providers face increasing challenges to recruit and retain staff. The longevity of staff is critical to providing quality services and enabling individuals to work and live in their communities. Direct support staff with two years' experience and 60 hours of training will be eligible to receive a wage increase starting in July 2018.

  • Ensure safety in delegated nursing. Funding will be made available to pay a nurse to conduct assessments, provide training, and consult with direct support staff performing health-related tasks delegated by a nurse.

  • Expands cost-saving opportunities for shared living. Ohio Shared Living is a cost-effective and stable alternative to 24-hour shift staffing. The budget aligns the rates of the two existing shared living services, Adult Family Living and Adult Foster Care. This provision will go into effect in the fall of 2017.

  • Fund program for multi-system youth with complex needs. In 2016, DODD worked to address growing concerns regarding youth with complex needs served by multiple state systems. The budget continues funding to improve outcomes for multi-system youth by avoiding out of state placement and custody relinquishment.

Private Intermediate Care Facilities

Since 2013, DODD has been working with stakeholders to modernize the ICF system. As a result, the number of ICF residents has decreased 6 percent, but the residents who remain have greater needs. The budget recognizes this dynamic and proposes to modernize ICF reimbursement to support residents with higher acuity.

  • Modernizes ICF reimbursement and increases rates. The ICF reimbursement system is more than 20 years old and in need of restructuring. The Ohio General Assembly recognized this need and has required DODD to form a stakeholder workgroup to modernize the system by the fall of 2017. Upon legislative enactment of the new reimbursement system in Fiscal Year 2019, the ICF reimbursement rate will increase by 2 percent.

  • Increases ICF reimbursement to cover complex care needs. Since 2013, the DODD has provided an add-on for children using ventilators. The operating budget removed the age requirement, so when children become adults they will not be discharged to a hospital or nursing home. This provision begins in the fall of 2017.

Thank You

Many of you have been involved in the budget process -- from providing input, to testifying, to contacting elected officials to share your thoughts on budget proposals. While there is still uncertainty around the Ohio Department of Medicaid budget, at this time, DODD does not see that uncertainty having a direct effect on the initiatives outlined above.

The department thanks you for your assistance, support, and suggestions, and looks forward to working with you to improve the lives of Ohioans with developmental disabilities.


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