Sources of funding 2012 ANNUAL CONFERENCE. Eligibility to receive services. Structure of County Boards of DD. Primary Service Programs

Transcription

1 OHIO ASSOCIATION OF AREA AGENCIES ON AGING 2012 ANNUAL CONFERENCE Dan Ohler, Executive Director County Boards of Developmental Disabilities Created by statute in 1967; SB 169. DD services previously merged with Mental Health and prior to that, Rehab & Corrections. Creation of county-based boards driven by families. Structure of County Boards of DD All 88 counties have a DD Board. Seven Volunteer Members Five appointed by County Commissioners, or the County Council. Two appointed by the Probate Judge, senior in large counties. At least three with an immediate family member eligible for services. Eligibility to receive services Must be diagnosed with a qualifying developmental disability that manifests prior to age 22. Children with developmental delays may also be eligible. Sources of funding Local Property Tax Levies. Federal Medicaid Assistance Percentage. State G.R.F. Appropriation. Primary Service Programs Early Intervention (birth through two) Pre-School (three to six) Habilitation Community & Supported Employment Residential 1

2 M L A A System Transformation County Boards of DD have Medicaid Local Administrative Authority per ORC Section 5126; passed in Amongst other things, this means each Board requests quarterly the number of waivers they can fund in their county. Growing demand for services, coupled with limited state funding, led to an unprecedented revision in state law. County Boards of DD would utilize local levy dollars to draw down F.M.A.P. via H.C.B.S. s, so long as they had M.L.A.A. (acronym reform). The Result... Significant growth in services for people with DD in Ohio fueled by waivers. Ten years ago, just over 5000 enrollees; today over 30,000 enrolled. Four waivers administered by County Boards of DD. National WAIVER ENROLLMENT All 50 states, plus D.C., have at least one waiver for people with developmental disabilities. New York leads nation with nearly 66K enrolled and spending of nearly $5B. Ohio has nearly 30K enrolled; approximately $1B in spending. Ohio now #4! Only New York, California and Florida exceed Ohio in waiver enrollment. Major change from 2000! From 47 to 41. Ohio leads the nation in local dollars used as Medicaid Match. 56% of national total. Ohio s D.D. s Level One Individual Options Self-Empowered Life Funding Transitions D.D. 2

3 LEVEL ONE LEVEL ONE This waiver was implemented in April, All 88 counties have individuals enrolled. Over 11,000 enrolled on the Level One. The average cost of Level One waiver services per person is just over $11,000. Consumers are required to meet the ICF level of care. Level One Services (Slide 1 of 2) Level One Services (Slide 2 of 2) Homemaker/Personal Care Institutional Respite & Informal Respite Transportation & Non Medical Transportation Environmental Modifications & Adaptations Specialized Medical Equipment & Supplies Personal Emergency Response System Adult Day Services Emergency Assistance Level One Budget Limitations (Slide 1 of 2) There is a $5000 annual limit on the following services: Homemaker/Personal Care Informal Respite Institutional Respite Transportation Adult Day Services in the Level 1 waiver has its own budget limitations (same as the IO ), governed by the AAI Instrument. Level One Budget Limitations (Slide 2 of 2) Level One also has an Emergency Assistance package for up to $8,000 over a 3-year period. In addition, every 3 years there is a $6,000 limit for any combination of: Emergency Response Systems. Environmental Accessibility Adaptations. Specialized Medical Equipment and Supplies. 3

4 Individual Options Individual Options This waiver was implemented on July 1, All 88 counties have individuals enrolled. Approximately 17,000 now served. The average cost of I.O. waiver services per person is approximately $55,000. IO Requirements Consumers are required to meet ICF level of care. Average aggregate cost of waiver services must be less than the statewide average cost of ICF services. Consumers are not restricted from enrollment based on age or county of residence. IO Services (Slide 1 of 3) Homemaker/Personal Care Adult Day Services Non Medical Transportation Adaptive and Assistive Equipment Environmental Modifications Adult Foster Care IO Services (Slide 2 of 3) Home Delivered Meals Nutritional Services Interpreter Services Social Work / Counseling Transportation Emergency Response System IO Services (Slide 3 of 3) Adult Family Living Remote Monitoring Remote Monitoring Equipment Community & Residential Respite 4

5 IO DATA Average daily rate: $159 per day Average hourly rate in system: $19.22 SELF Empowered Life Funding Percentage of individuals asking for a Prior Authorization: 10% Average overage for PA Requests: $22,000 Overview: SELF WAIVER Approved by CMS December, 2011, went live July 1, Up to 500 waivers available in FY 12, up to 2,000 available over 3 year period. 100 Slots for children with intensive needs will be state funded. ICF level of care required. Must be able to self-direct. SELF WAIVER Long-term vision for this waiver: Enhance participant-direction in Ohio. Serve as the long-needed middle level waiver in Ohio s system (i.e., level two). Help better address some crucial service needs. Improve flexibility and creativity for individuals and their families. We anticipate a slow up-tick to the waiver, because it is different and new. Transitions D.D. Transitions D.D. WaIver Developed as part of Ohio Home Care in Currently administered by ODJFS. Transferring to County Boards of DD in January

6 Transitions D.D. WaIver Waiting List Approximately 2,700 enrollees. Primarily a high level of medical need. Heavy use of nursing services. This waiver is CLOSED to new enrollment. Despite the growth in service delivery, every county has a waiting list for services. ORC includes priority lists for waiver enrollment; local decision. Permits level of need to trump first come, first served; local decision. 29 th Annual Convention December 5 7, 2012 Hilton at Easton 6