Information on 1500 Waivers under Settlement

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Dear Friend of ASO:

Information on the rollout of the waivers funded by the Ohio General Assembly in HB119 under the Settlement. Specific contact information is included. FYI - Please share.

Have you purchased your Ohio Autism Awareness License Plate yet? To purchase yours, visit www.oplates.com and click on "Specialty Plates" or visit our website at www.autismohio.org for more information.Sincerely,Barbara C. YavorcikPresidentAutism Society of Ohio701 S. Main St.Akron, OH 44311(330) 376-0211fax: (330) 376-1226email: askASO@...home: byavorcik@...web: www.autismohio.org Please note: This is provided for information purposes only. The ASO does not endorse or recommend any providers, methodologies or services. Providing this information should not be construed as an endorsement by the ASO, either explicit or impiled.

Check with your County Board of MR/DD to see if you are one of the individuals scheduled to receive a “ IO Waiver†during the next two years.

Check here to see how many state funded IO Waivers your county will receive. http://odmrdd.state.oh.us/topics/martin/settlement.htm

From ODMRDD’s Pipeline:

Settlement Waiver Rollout -- Where It’s At, Where It’s Going

For background information on the v. Strickland Settlement and other information on the subject, please visit the ODMRDD website at http://odmrdd.state.oh.us/topics/martin/settlement.htm

1500 Waivers -- v. Strickland settlement activity timeframe now underway

The state budget bill for Fiscal Years ‘08/’09 included funding for the v. Strickland settlement, which will enable an additional 1500 eligible individuals to choose community-based waiver services over a two-year period. The budget includes plans to enroll 600 individuals in Individual Options (IO) waivers between September 2007 and June 2008, and then an additional 900 individuals between July 2008 and June 2009. Enrollment will be phased, with 60 to 75 people enrolling each month.

Simply stated, that’s 1500 lives changed. And, changing 1500 lives is no small matter. The process by which this occurs must be well-conceived, methodical, and applied consistently statewide. What follows is a description of the process that has been developed, including the information that is being presented to stakeholders at meetings this month.

Concepts included in the allocation formula

The ODMRDD is the state agency responsible for implementation of the settlement. During the planning process, staff requested ideas from families, advocacy organizations, providers and County Boards of MRDD. Many of these ideas were included in the final allocation plan.

In addition, ODMRDD staff used statistical analysis to examine different factors related to the demand for waivers. These factors included county-specific waiting list information, the poverty level in each county, and the available tax assessments in each county. While developing this model, the ODMRDD analyzed responses to the survey of institutional residents that was conducted this spring. Lastly, the ODMRDD asked County Boards of MRDD about their administrative capacity to support additional waivers. For more information about the model and the allocation methodology, please send questions to Blair: franklin.blair@...

Implementing the allocation formula

Each County Board of MRDD is assigned a specific number of waivers to allocate to residents who live in that community. Each county will receive between 2 and 201 waivers over the two year period. While all 1500 waivers technically could be used to support individuals who are leaving institutional settings, a minimum of 280 waivers will be used for this purpose statewide. Each county board will receive a ‘base’ allocation that could be used to serve anyone (either currently living in the community or in an institutional setting). Then – depending on the size of the county and the statewide results of the survey of institutional residents – a county may receive an additional specific number of waivers to enroll only individuals moving from institutional settings.

Please click on this link http://odmrdd.state.oh.us/topics/martin/settlement.htm to view the county-by-county waiver allocation plan. In this document you will notice columns for each fiscal year, as well as county-specific requirements to serve a number of people from Developmental Centers (DCs) or Intermediate Care Facilities for the Mentally Retarded (ICFsMR) and Nursing Facilities (NFs).

Pilot Project, Gallipolis Developmental Center

The FY ‘08/’09 budget bill also includes a special pilot project for employees of the Gallipolis Developmental Center to provide waiver services to no more than ten individuals if the individuals select the DC as their waiver provider. This program will be developed this fall and requires federal approval before implementation occurs in 2009. Due to the number of details yet to be developed, the waiver allocation formula does not contemplate retaining a ‘reserve’ number for this project. The ODMRDD will identify waivers for the project at a later date.

Planned Timeframe of Waiver Allocation

In order to allocate the 1500 waivers over the two-year span, ODMRDD will work closely with County Boards of MRDD to plan the phased enrollment process. It is very important that the statewide enrollment progress matches up with the estimated timeframe for expenditures.

The ODMRDD will monitor each county’s progress very carefully and provide regular reporting to the public. If a county board is not enrolling according to its projected timeframe, ODMRDD will work with that county board to assist them in remedying any issues. In the event of special circumstances, the state reserves the right to reallocate the waiver to a different county if the original county board is unable to use the waiver within the expected timeframe. More information related to timeframe milestones is located on the ODMRDD website at http://odmrdd.state.oh.us/topics/martin/settlement.htm

Criteria for Selection of Enrollees

Named plaintiffs in the lawsuit: It is important to note that named plaintiffs in the v Strickland lawsuit will be guaranteed access to waivers, and county boards have been informed of the names of these individuals and instructed to enroll them.

Minimum 280 enrollees moving from institutional settings: Each county board may be provided a minimum number of individuals to be served from ICFsMR and from nursing facilities. (Note: Not every county has a specific minimum number for these categories.) In order to enroll individuals for these waivers, each county will have the ability to examine its waiting list information as well as the list of individuals who live in nursing facilities, ICFsMR or Developmental Centers who indicated that they would be interested in an IO waiver opportunity. County boards will then identify individuals who may use the waivers. Please note that an individual who indicated on the survey that he or she would like to move is not automatically entitled to a waiver.

Other enrollees: County Boards of MRDD have been given flexibility to serve the most pressing needs in its community. While a person’s position on the waiting list must be considered by the county board, it is not the sole determining factor for a waiver enrollment. In other words, the waivers present an opportunity for each county to serve the special needs of that community. Examples may include children with special health care needs, individuals with elderly caregivers, additional people moving from institutional settings, etc. Individuals now enrolled on Level One waivers are eligible to be considered to receive an IO waiver through the Settlement.

Payment Information

The waiver services for all 1500 waivers will be funded by the ODMRDD. It is our objective to enroll 1500 people over this two-year period. After that point, any additional waivers added will be subject to the availability of state appropriation.

In other words, if the General Assembly and the Governor authorize an increase, more individuals may be enrolled. If funding is held flat in Fiscal Year 2010 or beyond, then the ODMRDD will have to manage enrollment to a level that is affordable – and perhaps waivers would not be refilled when someone disenrolls. There is no guarantee of what will happen in the future, but ODMRDD will seek to advocate for funding to continue 1500 waivers (and possibly more.)

If one of the 1500 named individuals disenrolls from a Settlement IO waiver, the determination to provide a replacement enrollment opportunity to another individual in the same county will be made by the ODMRDD, based on the availability of enough general revenue funds to provide waiver services necessary to assure the individual’s health and safety.

These IO waivers are portable, and remain with the individual even when the individual moves from county to county. The ODMRDD will manage waiver availability to the level of the appropriation available.

In addition, at the time of their initial enrollment on the IO waiver all individuals participating in this initiative shall receive state matching funds for IO waiver services in amounts indicated by their Ohio Developmental Disabilities Profile (ODDP) scores and, if receiving Adult Day waiver services, with their Acuity Assessment Instrument (AAI). This funding covers any services approved through the Prior Authorization process, as long as the services are medically necessary. The ODMRDD has committed to providing increased matching funds over time if the needs of individuals increase as reflected in their AAI and ODDP scores and/or as approved through Prior Authorization.

In addition, no individual enrolled in a waiver shall reside in an unlicensed setting serving more than three other individuals with mental retardation or developmental disabilities.

Pipeline will provide more information on the Settlement waiver rollout

in the near future.

An action plan is being developed to identify specific ODMRDD staff for specific responsibilities, and to determine steps to be taken and implementation timelines to be met when expected enrollment lags or expenditure forecasts exceed projections. Please refer to www.mrdd.ohio.gov for more information soon. Specific questions should be referred to McAvoy at nancy.mcavoy@...

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