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With the heightened level of employment needs for individuals with disabilities, the time has come for rules within the Ohio Department of Developmental Disabilities to share the same language, beliefs and rate structure. What an exciting time to see not only a few rules revised, but the entire HCBS (Home and Community Based Services) application process for IO, Level One and SELF waiver go under review. It is apparent that Ohio is making a stand with employment and bringing it to the much needed forefront of individuals lives even when it comes to services in which they are receiving through a Medicaid funded system.

Home and Community Based Waiver Services- Application RevisionsWaiver Rules and Compliance

The Ohio Department of Developmental Disabilities (DODD) news publication on 5/9/16 highlights the changes to the HCBS waiver application process for IO, Level 1 and SELF waivers. Currently the revisions or noted ‘amendments’ have not been submitted to CMS (Centers for Medicaid Services) which means they are not final yet. Here are some general highlights of the amendments proposed:

Individual Options and Level One Waivers

  • Inclusion of the new Adult Day Waiver Services (ADWS) package – this allows for the ability to maximize opportunities for integrated employment and wrap around services
  • Inclusion of new service, Money Management – provides assistance to people with developmental disabilities who may need support managing personal and financial affairs
  • General modifications were made to the definitions within the rules to denote greater access to the individuals community and integration
  • New services and rate structures available including Career Planning, Individual Employment Support, Group Employment Support and Money Management
  • Service model definition revisions
  • Changes made to end Supported Employment-Community 9/30/16 and begin Individual Employment Support and/or Career Planning 10/1/16
  • Changes made to end Supported Employment-Enclave 9/30/16 and begin Group Employment Support 10/1/16
  • Additional limits of waiver services were also amended

SELF Waiver

  • Inclusion of the new Adult Day Waiver Services (ADWS) package – this allows for the ability to maximize opportunities for integrated employment and wrap around services
  • Amendment to eliminate sub-caps on the following set of services; Community Inclusion, Remote Monitoring, Residential Respite and Community Respite.  The overall cost limitation for this waiver will continue to be $25,000 per year for children and $40,000 per year for adults
  • New services and rate structures available including Career Planning, Individual Employment Support and Group Employment Support
  • Service model definition revisions
  • Changes made to end Integrated Employment as of 9/30/16 and begin Individual Employment Support and/or Career Planning Services 10/1/16
  • Changes made to end Supported Employment-Enclave 9/30/16 and begin Group Employment Support 10/1/16
  • Additional limits of waiver services were also amended

As noted above, the amendments listed here are not effective yet and will be awaiting CMS approval. However the proposed rule with revisions are expected to be effective 10/1/16. The Ohio Department of Developmental Disabilities will close input seeking on 6/8/16. Comments may be submitted by email to waiverfeedback@dodd.ohio.gov or by U.S. Mail to the Ohio Department of Developmental Disabilities, 30 E. Broad Street, 13th Floor, Columbus, OH 43215.

In conclusion, the movement at the state level to include employment into these dated rules is monumental. For both providers and county board personnel alike, all can agree that the rules, definitions and rate structures needed revision in order to keep in line with Ohio’s vision of Employment First. Much more to come on this topic and other rules effected.

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