County Board Guidance
The Ohio Department of Developmental Disabilities (DODD) remains dedicated to health and public safety as the department responds to coronavirus (COVID-19).
Ohio Department of Developmental Disabilities (DODD) COVID-19 Response Highlights
March 6, 2020: Ohio Department of Health (ODH) establishes a Call Center hotline and a website dedicated to COVID-19.
March 9, 2020: Governor Mike DeWine signed an Executive Order declaring a State of Emergency for COVID-19.
March 22, 2020: ODH Director, Dr. Amy Acton, issues Stay-At-Home Order effective 11:59 PM on March 23, 2020.
- DODD Guidance updated regularly and highlights are outlined according to subject matter in subsequent sections of this document.
- 03/11/20: Implemented web page for stakeholders to find all communications (updated daily) regarding COVID-19 field guidance and resources along with link to Ohio Department of Health COVID-19 website.
- 03/13/20: All regulatory compliance reviews and related actions suspended indefinitely effective at close of business 03/13/20.
- 03/14/20: DODD Regional Support Teams established and contact information/map shared with providers. DODD Regional Support Team Contacts include Community Resource Coordinators (CRC), the Office of System Support and Standards (OSSAS), Community Life Engagement (Policy-CLE), and regional liaisons for dual diagnosis in mental illness and intellectual disabilities (Policy-MI/IDD).
- 03/17/20: OSSAS reviewer staff are contacting each agency and independent provider and licensed facility to assess COVID-19 related needs – over 10,000 calls logged since 3/17/2020. Management staff have been working to triage health and safety concerns with service providers assessed during phone calls.
- 03/25/20: Payment was issued to providers of Adult Day, Employment, and non-medical transportation services for two weeks of services to help providers maintain operating costs.
- 04/10/20: Regional Residential Crisis Support Plan developed with step-by-step instructions on who to contact and when. Health and safety issues escalate to DODD Strike Team and State Emergency Management Team.
- 04/17/20: DODD Guidance to allow a temporary change to permit parents to provide waiver services to their minor children if the parent/step-parent is employed through an agency and the services are no participant directed.
- 04/30/20: Updated Financial Resources for all stakeholders.
- 5/6/20: DODD Guidance on COVID-19 Standards of Care for vulnerable population.
- 05/08/20: DODD Guidance on impending budget reductions.
- 06/12/20: Mandatory Staff Stability Survey 2019 deadline extended to 7-31-20.
- 7/20/20: OSASS returns to regulatory work August 1, 2020
People with Developmental Disabilities and Families
- 3/14/20: DODD’s Statewide Support Teams Available for COVID-19 - 3/14/2020 – allows individuals/families/guardians access to DODD staff based on region/county.
- 3/19/20: Guidance for Prevention of COVID-19 and a response for individuals and families for home waiver settings – 3/19/2020 – provides handouts from ODH, CDC, and DODD with checklists and information to use with individuals. Also provides guidance for situational responses if/when someone presents with symptoms of COVID-19.
- 04/02/20: Video Message to Families from DODD Director Jeff Davis.
- 04/02/20: Guidance: Best Practices for Family Visitation to Residential Settings – 4/2/2020 –explains to families/guardians/advocates the need for restrictions, as well as providing tools for their use.
- 04/10/20: What COVID-19 Means for Families – 4/10/2020 – provides links to the governor’s Executive Order declaring a state of emergency, order prohibiting Adult Day and Employment services in congregate settings.
- 6/24/2020: The Nisonger Center at The Ohio State University has prepared a national survey for adults, age 18 or older who have IDD to provide feedback on their experiences during this COVID-19 Pandemic. The intent is to learn how practitioners, employers and others can better support people with developmental disabilities during a time like this.
- 06/24/2020: APSE: COVID-19 Survey on the Impact on Disability Employment Services https://www.surveymonkey.com/r/7PQZSX2
- Frequently updated resources:
- 03/19/20: Plain Language information on CCOVID-19 and COVID-19 Information for Families.
- 03/20/20: Social Stories to help people understand various aspects of COVID-19.
- 03/27/20: Charting the LifeCourse Integrated Star for Social Distancing: provides suggestions for making social distancing less frightening and more meaningful for individuals and families.
- 03/27/20: Having a Meaningful Day during Ohio’s Stay-at-Home Order : discusses things to do during this stressful time.
- 03/30/20: COVID-19 Frequently Asked Questions.
- 04/02/20: Plain Language About Day Programs Closing.
- Links to Family Connection Newsletters – 3/13/2020, 3/20/2020, and 4/2/2020
- Checklists for Home and Family and People from ODH
- Documents on Staying Healthy – Self-Monitor and Practice Social Distancing (ODH) and Cleaning 101 Presentation
- 7/10/2020: DODD launches “Growing Family Resilience” module, provides resources and tools to help understand the role of trauma, and learn techniques to be resilient (Growing Family Resilience Module)
- 7/10/2020: The BOLD Beginning website is a way for Ohio’s parents, grandparents, care givers, teachers, and child care providers to access resources related to early childhood from Ohio’s state agencies (BOLD Beginning website)
Guidance for All Service Providers, County Boards, and COGs
- 03/13/20: DODD Guidance on ADS and Employment agencies subcontracting ADS/Employment staff with residential and respite providers.
- 03/18/20: DODD Guidance: Rule Relief for Medication Administration Certification Renewals. Personnel with a current history of current medication administration may continue to administer medications for up to 180 days past expiration date for all certification categories.
- 03/19/20: DODD Guidance: Health and Safety Supplies including Personal Protective Equipment (PPE), household disinfectant, and other needed supplies coordinated through local County Boards. Local County Boards advised to coordinate with local Emergency Management Agencies and cooperative purchasing with Ohio Department of Administrative Services.
- 03/20/20: DODD Guidance: Face-to-face PASRR requirements suspended, Level of Care expiring before 06/01/20 will be approved by DODD, Pre-Admission Counseling on hold until further notice. Ohio Department of Medicaid continuing all current Medicaid eligibility until further notice.
- 03/23/20: DODD Guidance: Provider Certification Span 90-day Extensions for Upcoming Renewals in March through May.
- 03/26/20: DODD Guidance issued regarding Behavior Supports/Rights Restrictions. Current restrictive plans to extend throughout the state of emergency without HRC approval and new plans should follow the emergency procedure through the County Board of DD or ICF. Rights restrictions imposed on all Ohio citizens under the orders of ODH and Governor’s office are not considered rights violations for persons with developmental disabilities.
- 04/02/20: DODD Guidance: All Home Modifications/Environmental Accessibility Adaptation requests on hold unless there is an immediate risk to health and safety.
- 04/15/20: DODD Guidance on Residential Respite Services and temporary approval to lift maximum days allowed identified in waiver rules.
- 04/16/20: DODD Guidance on Long-Term Services and Supports (LTSS) Pre-Surge Planning Toolkit. Comprehensive planning tools developed to assist providers in planning for potential future COVID-19 outbreaks. (dodd.ohio.gov/wps/portal/gov/dodd/about-us/communications/news/news-guidance-ltss)
- 05/08/20: EI training opportunities Program updates.
- 06/05/20: Non-Medical Transportation Guidance Rescinded – providers encouraged to follow guidance set forth by the Ohio Department of Health, local health department, CDC guidelines for vehicle operators and passengers.
- 06/05/20: Responsible Restart Ohio guidance for Residential Camps and Day Camps.
- 06/12/20: CARES Act Provider Relief Fund Application, Guidance.
- 06/12/20: Ohio Development Services Agency provides grants to help businesses owned and operated by minorities and/or women in response to COVID-19.
- 07/10/2020: DODD announces a free online training module “Did You Notice?” for direct support professionals
- 07/20/20: Guidance update to behavior supports
- 7/23/20: at 6:00pm all Ohioans must wear a face covering when in public (exceptions listed in the order).
- 7/23/20: Governor issues a travel advisory and recommends 14 day quarantine if traveling from specific list of states.
- 7/24/2020: The modified reimbursement at the Acuity C rate, for services in a group of 10 or less, occurring at a center-based Adult Day Program, per previous guidance is scheduled to continue through August 31, 2020. This will be reviewed every 30 days as agreed upon. DODD will issue communication monthly to share the outcome of each review.
- 7/24/2020: - Advocacy & Protective Services, Inc., the Ohio Association of County Boards of DD Ohio Health Care Association, the Ohio Provider Resource Association, and Values and Faith Alliance have compiled recommendations for teams that are engaging in discussions about home and community-based services for people with developmental disabilities.
- 03/13/20: DODD Guidance that Remote Support can be authorized for 24 hours per day or fill gaps if unexpectedly there is not support available from a direct support professional. Remote Support hours may be authorized during COVID-19 to assist individuals whose needs can be safely met remotely, for what hours, and backup support as identified by teams.
- 04/13/20: DODD Guidance on Supportive Technology Options: Equipment for Remote Support may be authorized under the Assistive Technology service as a one-time expense or monthly rental/lease.
- 07/24/20: With grant funding from the Ohio Developmental Disabilities Council, the Ohio Center for Autism and Low Incidence (OCALI) is able to offer a variety of training opportunities, online resources, develop a Community of Practice, and provide financial assistance to obtain advanced certifications in Assistive Technology.
- 03/26/20: DODD Guidance on Expediting Background Checks for new DSPs.
- 04/10/20: DODD created a recruitment kit to help bring on new DSPs with advertising materials, videos and social networking links/info.
- 03/30/20: DODD relaxed many requirements for initial onboarding and training of DSP’s https://dodd.ohio.gov/wps/portal/gov/dodd/about-us/resources/resource-onboarding-dsps
- Agency providers hiring independent providers for direct services permitted to forgo all hiring requirements if an independent provider is currently certified by DODD. Agencies contracting with other agencies to lend direct care staff will need to verify staff have met all hiring and training requirements. Links to Ohio Means Jobs employment site provided https://jobs.ohiomeansjobs.monster.com/
- Providers may explore the availability of an alternative workforce, such as college students or people without high school diplomas or GEDs, as well as the possibility of working with local county boards of developmental disabilities to identify other potential groups of people in local communities. Applicants under 18 years old required to have a rule waiver approved by the department.
- CPR and First Aid training may be taken online through 05/31/20. Condensed initial training approved for MUI/UI reporting and Universal Precautions. Link to free online training provided by Ohio Association of Direct Service Professionals https://www.oadsp.org/dsp-abbreviated-training/
- 04/01/20: DODD Guidance on Initial Medication Administration Remote Training temporary approval during state of emergency. 06/05/20: Updated guidance reminding providers that rule relief expires 08/01/2020.
- 05/11/20: The American Red Cross and the American Heart Association have extended expiration dates for CPR and First Aid for 120 Days. Also, if online CPR/FA certification was taken, appropriate certification must be obtained by 6/1/20 if the staff person maintains a direct support position. This accommodation will now be in effect until further notice. American Red Cross instructors are providing provisional training and certificates which allow for the online portion to be started and a 90-day period for the hands-on component to be completed.
County Boards of DD/COGs
- 03/12/20: DODD Guidance on Early Intervention services regarding intake and current services. EI service team members encouraged to use technology as much as possible for evaluations and assessments.
- 03/13/20: DODD Guidance on County Board Recommendations including SSA functions. County Boards are the primary point of contact for providers for staffing and supply needs to ensure health and safety of individuals and provider staff. SSA’s are providing constant monitoring of individuals ensure needs are being met to ensure health and safety.
- 03/16/20: DODD Guidance on MUI and Registry Unit functions and coding COVID-19 related hospitalizations and deaths.
- 03/18/20: DODD Guidance on County Board Cost Projections submission deadline suspended indefinitely. County Board Cost Report deadlines for submission to remain the same.
- 03/19/20: DODD Guidance on RN Quality Assurance reviews put on hold until at least 05/31/20.
- 03/19/20: DODD Guidance on Billing Concessions effective 03/12/20.
- Webinar Employment services and COVID-19.
- 05/04/20: SSA Check-in Tips for Communication with persons served, families, providers, and guardians.
- 07/17/20: EI program updates # 2018 (https://dodd.ohio.gov/wps/portal/gov/dodd/about-us/communication/newsletters/newsletter-early-intervention-2018)
Intermediate Care Facilities (ICF)
- 03/13/20: DODD Guidance on waiving prior authorization for additional bed hold days.
- 03/18/20: DODD Guidance for ICF’s regarding surveys, options counseling, levels of care, and individual service plans.
- 03/20/20: DODD Guidance on ICF Situational Response. Topics include restricted access to and from ICF, entry screening process tool, use of PPE, and actions to take for suspected and confirmed cases of COVID-19.
- 04/04/20: DODD Guidance on temporary suspension of DDP and IAF assessment requirements.
- 06/05/20: ICF Visitation guidance (https://dodd.ohio.gov/wps/portal/gov/dodd/about-us/communication/news/news-guidance-icf-visitation).
- 07/24/20: The Coronavirus Relief Fund (CRF) Webinar recorded July 27, 2020 provides helpful guidance to ICFs related to the use, cost reporting, and tracking of CRF funds. Providers can find a recording and training materials here.
Residential Waiver Providers and Direct Service Professionals (DSP)
- 03/16/20: DODD Guidance provided regarding suspected COVID 19 in staff and/or individuals.
- 03/20/20: DODD Guidance on Entry Screening Process for Prevention of COVID 19 Transmission Tool for staff and visitors.
- 03/30/20: DODD Guidance on Electronic Visit Verification (EVV) requirements and guidance outlined. Providers without EVV training not required to take training or utilize EVV until further notice.
- 04/02/20: DODD Guidance shared for best practices for family visitation to residential settings. Rescinded effective 06/05/20 and replaced with new guidelines for family visitation to residential settings (https://dodd.ohio.gov/wps/portal/gov/dodd/about-us/communication/news/news-guidance-waiver-visitation).
- 04/02/20: Links to videos and guides to help providers explain to individuals the need for social isolation and what to do to help have a meaningful day during changing times.
- 04/03/20: DSP Connection on-line newsletter provided links to information for DSP’s to help them provide quality service during this time and for their own health/well-being.
- 04/13/20: DODD Guidance Providers are encouraged to utilize all available staff in the provision of direct support, including management and clerical staff, as examples.
- 06/5/20: Waiver Visitation Guidance (https://dodd.ohio.gov/wps/portal/gov/dodd/about-us/communication/news/news-guidance-waiver-visitation)
- 03/14/20: DODD Guidance that licensed facilities may operate over capacity with expedited rule waiver approval.
- 04/17/20: DODD Guidance on Licensure Development - no new facilities will be licensed until after June 1, 2020, unless the need to license the facility is due to an emergency. If it is determined that a new facility needs to be licensed due to an emergency, DODD will conduct an abbreviated, virtual feasibility of the facility. An on-site feasibility will be conducted after 06/01/20.
- 04/17/20: DODD Guidance on Licensed Facilities and Local Triage Zone Question. https://dodd.ohio.gov/wps/portal/gov/dodd/about-us/communication/news/news-guidance-licensed-facilities-local-triage-zone
- 04/17/20: DODD Guidance on License Expiration Dates for Licensed Facilities – all residential facility licenses issued by DODD have automatically been extended through November 30, 2020.
- 04/13/20: DODD Guidance that allows for weekly hours served ceiling to be increased if necessary, with team approval.
- 04/13/20: DODD Guidance encourages independent providers to explore alternative service delivery methods, such as the use of Remote Support or allowing people to receive services in the homes of independent providers, with team approval.
Adult Day Service (ADS) and Employment Services
- 03/13/20: DODD Guidance that ADS services authorized to be provided in residential settings.
- 03/21/20: Modified per the executive stay-at-home order to limit total number of persons at onsite ADS programs.
- 04/09/20: DODD Guidance states 1.) ADS services can be delivered on behalf of or in the home of a person with disabilities and 2.) ADS services can be delivered through technological means, such as by phone, tablet, or other electronic options.
- 5/6/20: Director video talking about adult day services under ODH order. Webinar for Employment Services and COVID-19 guidance. (https://dodd.ohio.gov/wps/portal/gov/dodd/about-us/communication/news/news-employment-services-webinar)
- 5/8/20: Introduction of STEP ADS/VH service modifications and rate reimbursement change.
- 5/11/20: Provider Assurance Form process implemented by OSSAS to ensure readiness for limited reopening of facility-based Adult Day and Employment services and non-medical transportation.
- 5/26/20: Updated Adult Day Service Guidance including the Risk/Benefit Discussion Guide, Team Acknowledgement Form, Provider Assurance Form, and Symptom Monitoring Log tools. Guidance on Reimbursement to Adult Day and Employment Service providers clarifying that STEP and facility-based services may not be billed on the same date. (https://dodd.ohio.gov/wps/portal/gov/dodd/about-us/communication/news/news-guidance-covid-19-updated-ads-guidance)
- 6/10/20: Updated ADS, VH, ICF Day Program, and Transportation COVID-19 Risk/Benefit Discussion Guide. (https://dodd.ohio.gov/wps/wcm/connect/gov/71186d1d-f0b2-46b5-8187-ea7610d3c13d/Risk+Benefit+Discuss+Form+Fillable.pdf?MOD=AJPERES&CONVERT_TO=url&CACHEID=ROOTWORKSPACE.Z18_M1HGGIK0N0JO00QO9DDDDM3000-71186d1d-f0b2-46b5-8187-ea7610d3c13d-navJBmE)
- 6/10/20: Issued Guidance: Reimbursement for Center Based Services—adjusts the payment for services to reflect the required smaller group sizes. This guidance details for provider agencies the specific billing codes created to adjust for this rate and the corresponding PAWS Roll-up Codes.
- 06-15-20: Guidance to Adult Day service providers on new waiver service code options. https://dodd.ohio.gov/wps/portal/gov/dodd/about-us/communication/memos/memo-billing-codes-ads
- 7/2/2020: Governor issues a Public Health Advisory system, a color-coded system based on 7 data indicators. This system consists of 4 levels-Level 1 (yellow), Level 2 (orange), Level 3 (red) and Level 4 (purple). As of 7/9/2020 7 counties are at a Level 3.
- 7/8/2020: The Ohio State University develops a survey (the Nisonger Survey) for adults with disabilities to share their experiences during COVID-19.
- 7/14/20: Update to reopening guidance for transportation and Adult Day Services.
- 7/24/20: DODD updated the corresponding forms referenced in the July 14 updated guidance for adult day services. The guidance and the Team Acknowledgement Form include references to COVID-19 testing.
- 12/08/20: To allow more flexibility for local counties and providers during the state of emergency, DODD is extending the Outcome Tracking System (OTS) reporting period to June 30, 2021. At that time, the data normally due in March will be required to be entered to better understand how people with developmental disabilities services are spending their days.
Behavioral Supports, Including Rights Restrictions
Updated September 25
Any plans with new behavioral support strategies must be developed following the behavioral supports rule, 5123-2-2-06. Any plans that were put in place or continued during the emergency and not following the rule, but as instructed in prior guidance issued by the Ohio Department of Developmental Disabilities (DODD), must be evaluated for necessary action by December 31, 2020. For example, if regular team reviews have been suspended, these reviews should begin again. Each county board of developmental disabilities and intermediate care facility (ICF) should develop a process so that each person’s plan is reviewed by the team by December 31, 2020. Thereafter, plans must be reviewed every 90 days. Meetings may be held virtually.
Similarly, if, under prior DODD guidance, plans with behavioral support strategies were implemented without human rights committee (HRC) review and approval, each county board of DD and ICF should develop a process to begin reviewing these plans and seeking HRC approval when necessary. DODD understands that county boards of DD and ICFs may have suspended restrictive measures notification (RMN) entries during the emergency. We expect county boards of DD and ICFs to begin implementing the process to accomplish all these activities now. However, the department also realizes that it will take some time to put everything in place. All plans should meet the requirements of the behavioral support rule by January 31, 2021. HRC meetings may be held virtually.
DODD Support Teams
In this critical time, everyone will be required to work collaboratively, operate differently, and be proactive to limit the spread of COVID-19. During this state of emergency, DODD fully realizes there are on-the-ground issues that require flexibility from normal operations and additional assistance from the department.
DODD support teams are available and consist of staff ready to help county boards and providers.
DODD has set up a dedicated web page for department communications and links to helpful resources that will advise people with disabilities, their families, service providers, direct support professionals, county boards of developmental disabilities, and the community at large.
For specific questions about COVID-19 and additional information and resources, DODD urges you to use the Ohio Department of Health’s call center. Call 1-833-4-ASK-ODH (1-833-427-5634), or visit coronavirus.ohio.gov.