Thursday Jan. 15, the Logan County Board of Developmental Disabilities Board discussed changes to the Federal definition of “Home and Community Based Services” which will effect Medicaid funding and changes to the timeline to implement “conflict free case management.” These changes will directly affect county board services.
Superintendent Saul Bauer highlighted information regarding a correspondence sent from Disability Rights Ohio (formerly Ohio Legal Rights).
For years, Disability Rights Ohio (formerly Ohio Legal Rights) has heard from many people with developmental disabilities and their families that Ohio’s system does not give them opportunities to live, work, and spend time in their communities.
People with disabilities should not be grouped together and separated from everyone else just because they have similar needs. Ohio has people living in facilities who want to live in their own homes in the community. Long waiting lists for waiver programs mean that most people have to wait over 13 years for the services they would need in the community.
The law also requires these changes. The Americans with Disabilities Act became law in 1990, and the Supreme Court made its decision in L.C. v. Olmstead in 1999. A state must provide services to people with disabilities in the most integrated, least restrictive setting in the community appropriate to their individual needs. Over the years, Ohio has not changed its service model to comply with the law, leaving thousands of people in facilities when they would like to live and work in the community.
The average wages for direct care staff who support people with developmental disabilities in the community are below poverty level and there is far too much worker turnover (47 percent). No one’s family should be expected to provide support or care if they are unable to do so.
Any changes should be made carefully. This may require many years to do. The state should not act too quickly and put people at risk.
DRO is not asking the state to close facilities or workshops, but programs may need to change based on the choices made by the people they serve. When more options become available to live or work in the community, people may choose these instead of facilities or workshops. When this happens, demand for facilities or workshops may fail and some could close.
Centers for Medicare and Medicaid Services is a federal agency that makes the rules for each state’s Medicaid program, and the public has a right to provide input on the state’s plan.
The U.S. Department of Justice, another federal agency, has been very forceful lately in making sure states follow the ADA and Olmstead. Ohio is vulnerable to a formal investigation by the DOJ because of the high number of people living and working in facilities who do not have options in the community.
DRO is not advocating that any services be cut or eliminated.
Board member and Vice President Mrs. Bonnie Versele attended the public forum for Ohio’s CMS transition plan in Cincinnati on Jan. 11. She shared a few details of the experience with us because the forum was quite interesting.
Not knowing what to expect, she got there a few minutes before 10 a.m. and had to double-park. When she got to the room they were already bringing in extra chairs. She estimated there were about 200 people in attendance. Mrs. Versele didn’t know if the majority of the attendees would be DD staff members, county board members, providers, or concerned family members, but during the second hour it became apparent that there were a lot of family members in attendance.
The first hour was primarily going over the PowerPoint presentation that I had sent to her prior to the meeting.
The second hour was much more interesting. The parents in attendance had plenty to say, some bordering on outrage. Without exception, family members are upset and frightened that their adult children’s residential settings and sheltered workshops are going to be closed or at least drastically changed. Most agreed that it’s hard to argue with the goals, but the language is so vague that it is impossible to understand, and many seem to feel that this is intentional. Needless to say, this breeds distrust. One lady said that this was the third forum she had attended and that she is tired of hearing the same canned answers to her questions.
Mrs. Versele said she, too, felt the presenters’ responses were quite canned. Another gentleman pointed out that there is a huge difference between intent and implementation and quite eloquently stated that “the road to hell is paved with good intentions.”
Mrs. Versele said she could go on and on about statements that were made, but the ones that stood out were from two attorneys who have adult children (one a daughter, the other a son) at Safe Haven Farm in Butler County. The first gentleman did not identify himself as an attorney and was one of the few people in the room who seemed to sympathize with the presenters, and they were the target of a lot of anger. He said that he understands that they are trying to put meat on a skeleton with very little direction. He is very concerned about vague definitions and what he calls the fear factor. It was a bit later that the second gentleman spoke up and stated that they are both attorneys and went on to tell how happy they are with Safe Haven Farm, how their children are thriving at the workshop, etc. He emphatically declared that the DRO does not speak on behalf of everyone to which he received a long and loud round of applause. He said that he and his friends are working with politicians and also emphasized that the language must be cleared up.
The audience also wanted to know who completed the survey that brought about these changes. Many people in the room said they were not asked to complete a survey.
The speakers did an excellent job as they explained the details as we know them at this time. Change is always difficult and at this point we do not have the final details of the exact plan. Patience will be a virtue as we wait for the final plan.
Logan County is fortunate in that we have a variety of choices for individuals with developmental disabilities and we are prepared to smoothly transition to be compliant once the final details are announced.