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Ohio

Task Force

Created by executive order in June 2000, the task force-called Ohio ACCESS-issued its comprehensive report to the governor on Feb. 28, 2001. The report, Ohio Access for People with Disabilities, is located at www.state.oh.us/age/ohioaccessrpt.pdf

As part of Ohio ACCESS, the governor directed the director of the Office of Budget and Management, along with the Ohio departments of aging, alcohol and drug addiction services, health, job and family services, mental health, and mental retardation and developmental disabilities, to conduct a comprehensive review of Ohio's services and supports for people with disabilities and to make recommendations for improving services during the next six years. The governor also mandated that people with disabilities and their representatives participate in the review and development of the recommendations.

Ohio ACCESS, led by the Medicaid program, consisted of the directors of all the relevant agencies. The short-term recommendations focused on customer services; the long-term recommendations focused on workforce issues. The commission is giving priority to the needs of people with developmental disabilities and people with physical disabilities. Within these disability groups, the commission focused on strategies for moving people out of institutions.

The Plan

Overall, the cornerstones of the Ohio ACCESS vision are consumer self-determination and a people-centered planning approach with assistance from family, friends and caregivers. The recommended strategies for overcoming barriers to achieving the vision include:

• Matching capacity with the demand for community-based services.
• Generating and sustaining the necessary resources to expand community services.
• Overcoming federal policy constraints such as the federal Medicaid waiver.
• Addressing the health care workforce shortage by creating a public-private workgroup; conducting a labor market analysis; studying wage and rate issues. creating demonstration projects to examine career ladders, scholarship opportunities, and payments to family members and other informal caregivers on a controlled basis; examining alternatives to the traditional provision of long-term care by looking at scope of practice issues, assistive technology; and the increased use of independent service providers.
• Overcoming policy constraints on self-sufficiency and personal and family responsibility by providing better information and assistance for consumers and their caregivers.

In addition to the recommendations, the report contains:

• An overview of state-supported, community-based long-term care services in Ohio;
• The currently offered community services for people with disabilities;
• Federal constrains that have contributed to the current institutional bias present in publicly funded programs; and
• Challenges to state policy that exist and must be addressed for the vision of the report to be implemented.

Implementation

There was no legislation related to the Olmstead decision in 2002.

The FY 2002-2003 appropriations included:

• Adding 1,300 slots in FY 2002 and another 1,600 slots in FY 2003 to the PASSPORT waiver program, which provides care to people over age 60 who otherwise would need nursing home services (the program currently has more than 24,000 slots);
• Adding 500 slots in both FY 2002 and FY 2003 to the Home Care Waiver Program, which provides care to disabled people under age 60 or people of any age with a chronic, unstable condition who require nursing care (the program currently has 8,200 slots);
• Adding 500 slots in both FY 2002 and FY 2003 to the Individual Options Waiver Program, which serves people who otherwise would require institutionalization in an intermediate care facility for the mentally retarded (ICF/MR);
• Establishing an Ohio Success pilot program to fund up to $2,000 in transition costs for 75 people in FY 2002 and 125 individuals in FY 2003 to be used as seed money for the first month's rent, utility deposits, moving expenses and other related costs;
• Developing cost management tools that promote choice and personal responsibility;
• Redesigning the mental retardation and developmental disabilities Medicaid delivery system by moving the Community Alternative Funding System Program to a fee schedule and by making the transition to new home and community-based waivers; and
• Improving cost management tools within the community mental health system.
  

A class action suit, Martin vs. Taft, is pending in federal court on behalf of 6,000 adults with developmental disabilities on Medicaid waiver waiting lists. For an update on lawsuits in Ohio and other states, see Status Report: Litigation Concerning Medicaid Services for Persons with Developmental and Other Disabilities by Gary A. Smith at http://www.hsri.org/index.asp?id=news

The Ohio Department of Job and Family Services received a $1.385 million Real Choice Systems Change Grant. The money is being used to create a program titled "No Wrong Door." The approach of this program is to coordinate services and work in collaboration with the Department of Aging to establish a database of available services throughout the state and make the database accessible to everyone (providers, consumers, etc.)

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